Nursing Commons^™

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …

Sleep Disruptions Within The Hospital, Faith Walls

Senior Honors Theses

The circadian rhythm is a complex and interwoven system within each human being that creates an internal clock each day. However, patients in all hospital settings continue to have their sleep disrupted by many factors. Seep being disrupted in the hospital patients can develop serious complications. To this day, the issues causing have not been adequately assessed and therapeutically intervened with consistency within nursing practice. Using the Whittemore and Knalf Framework, this integrative review will examine the literature on aspects of inpatient care that contribute to circadian disruptions within hospitals. By doing so, the research can be built upon with …

Non-Opioid Pharmacologic Agents In The Treatment Of Non-Cancer Chronic Pain In The Outpatient Setting, Diane Eannotti

DNP Projects

Opioid prescription related overdose deaths have increased substantially with evidence demonstrating only modest short-term benefits in chronic pain and thus represents the need to identify alternative treatments to opioids. A needs assessment performed for a federally qualified community health center revealed patients presently taking non-opioid pharmacologic agents in the treatment of chronic non-cancer pain (CNCP) needed additional education in managing multiple non-opioid medications. A targeted approach at improving patient experience and population health supporting the quadruple aim was undertaken with this project.

Purpose: The purpose of this quality improvement project consisted of performing medication management visits for 28 referred patients …

Developing An Evidence-Based Preceptor Program To Improve The Orientation Process, Emily Nobles

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

Background: Creating a positive experience for the new nurse during the orientation period is vital in ensuring safe practice, employee satisfaction, and improved self-efficacy and retention of the employee long-term. Problem: At a 245-bed acute care hospital in the southeastern United States, nursing retention and preceptor practices have surfaced as an opportunity for improvement. Methods: A quality improvement project involving the implementation of an evidence-based preceptor program with formal preceptor education, preceptor application, and a standardized feedback tool was evaluated to determine the effect on preceptor/preceptee self-efficacy, intent to stay, and preceptor engagement. Results: 10 preceptor-preceptee pairs with previous nursing …

2022 Nursing Annual Report, System Of Texas Children's Health

2022

No abstract provided.

Preventing Failure To Rescue: Implementation Of An Early Warning Score System, Caitlyn Holloway Msn Rn Ccrn-Cmc Pccn Tcrn

Doctor of Nursing Practice Projects

Background: Hospitalized patients are at inherent risk of complications and further clinical deterioration, even in the presence of advanced medical interventions and expert caregivers, with the most significant risk being failure to rescue. Early Warning Score (EWS) systems allow for earlier, more effective identification of clinical deterioration than traditional medical emergency team (MET) systems and provide an opportunity to reduce failure to rescue events and improve patient outcomes.

Objective: The purpose of this quality improvement project was to implement an EWS system that allowed bedside caregivers to improve patient outcomes through reduction of failure to rescue events and improvement of …

Mental Health First Aid (Mhfa): Implementing An Evidence-Based Practice Change Initiative In A School Setting, Kate Wachutka Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: School-aged children with unidentified mental illnesses experience poor health outcomes and increased medical costs. Successful management of this public health threat requires a collaborative community approach with a focus on enhancing adults’ mental health literacy (MHL) to improve outcomes.

Objectives: The objectives of this project were to implement an evidence-based mental health education (utilizing MHFA) and sustainment program within a school setting for staff and parents supervising children to optimize the adults' MHL over a three month period.

Methods: A pretest-posttest design was used. Participants were recruited from a school in the Western United States. Inclusion criteria consisted of: …

Implementing Sskin Bundle For Pressure Ulcer Prevention In Long-Term Care Facility, Funmilayo Oni

Doctor of Nursing Practice Projects

Background: Pressure ulcers are a major challenge in long-term care (LTC) facilities. Adult patients in LTC setting are at risk for developing pressure ulcers due to chronic medical conditions and comorbidities. Preventing the onset of these wounds is more cost-effective than treating pressure ulcers.

AIM/Objectives: The primary objective was to decrease the number of pressure ulcers by 50% within a three-month period. Secondary objectives were to achieve 100% compliance with completion of mandatory staff education, score on the posttest questionnaire, and compliance with mandatory staff documentation as instructed by the SSKIN protocol.

Methods: This DNP Project used a pretest and …

Antibiotic Stewardship For Asymptomatic Bacteriuria In Older Adults Residing In Long-Term Care At End-Of-Life, Kimberly Madison Agpcnp-Bc

Doctor of Nursing Practice Projects

Background: Differentiating between asymptomatic bacteriuria (ASB) and urinary tract infections (UTIs) in older adults is challenging due to their atypical presentation. There is a critical gap in practice to adhere to clinical guidelines advising against treating ASB with antibiotics.

Objectives: The purpose of this Quality Improvement project was to implement an antibiotic stewardship program at a hospice organization to standardize judicious use of antibiotics at the end-of-life. The outcome measures were designed to evaluate clinician knowledge, prescribing policies and practice changes, the completeness of documentation, the appropriate usage of antibiotics, and clinician antibiotic use attitudes and beliefs.

Methods: Hospice clinicians …

Structured Type 2 Diabetes Education To Improve Self-Monitoring Blood Glucose, Self-Care Management, And Diabetes Knowledge In A Multicultural Family Practice Clinic, Deedee Foster Fnp-C

Doctor of Nursing Practice Projects

Background: The family practice providers at the family medicine residency clinic (FMRC) have neither sufficient time nor continuity of care to provide diabetes education to effectively reduce A1c levels. The FMRC has 500 multicultural type 2 diabetes patients with an A1c >7% that has increased by 23.2% in the previous five months. Multiple studies have demonstrated that structured diabetes education can significantly decrease blood glucose readings, improve self-care management, and diabetes knowledge to attain optimal glycemic control.

Objectives: To implement an evidence-based practice (EBP) project in the FMRC to improve participants blood glucose readings, self-care management, and diabetes knowledge.

Methods: …

Effect Of A Web-Based Educational Intervention In Improving Depression Knowledge And Help-Seeking Behaviour In Women, Chibuzo Efuribe Rn Msn Fnp-Bc

Doctor of Nursing Practice Projects

Background: Depression is of global concern and one of the leading causes of disability in the United States. Based on a needs assessment conducted in a faith-based organization, we noticed a gap in depression knowledge, an unwillingness to seek help, and a lack of open dialogue among the women. Studies have shown that low depression literacy impedes early recognition, prevention, and willingness to seek help (Brijnath et al., 2016; Reavley et al., 2014).

Aims: This study aimed to evaluate the effects of web-based educational intervention in improving depression knowledge and help-seeking behavior among women in a faith-based organization.

Methods: Using …

Program Evaluation Of Leader Rounding In Emergency And Trauma, Allen Fasnach Msn, Rn

Doctor of Nursing Practice Projects

Background: Patient satisfaction scores are an area of priority for hospitals throughout the United States because of their association with quality outcomes for the patients (Davenport, O'Connor, Szychowski, Landry, & Hernandez, 2017). This healthcare organization implemented the practice of nurse leader rounding over the last five years with the goal of leaders rounding on 75% or greater of the units' populations without any organizational sustainment or achievement of upper decile patient satisfaction scores.

Aims: The aim of this project was to utilize the Centers for Disease Control Framework for a Program Evaluation to evaluate the redesigned leadership rounding program for …

Effectiveness Of Provider Education To Improve Screening, Diagnosis, And Management Of Postpartum Depression, Gina M. Tytula

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) effects approximately 15% of new mothers after the birth of their child which results in feelings of anger, fear and being overwhelmed. In the practice setting for this project there were low rates of PPD screening, leading to missed diagnoses and inadequate management of PPD.

Purpose: The purpose of this project was to implement and evaluate the effectiveness of an education program to increase providers’ perceived knowledge and improve screening, diagnosis and management of PPD for a multicultural patient population at an urban obstetrics practice.

Methods: This pre-post design project evaluated the effectiveness of an educational …

Evaluating Telehealth As A Means Of Communicating With Living Donors And Its Effect On Quality Of Care, Ashley Anne Hamby Rn Msn

Doctor of Nursing Practice Projects

Background: Despite the advantages of living donor kidney transplantation (LDKT), there are barriers that potential donors face that make living donation less appealing. Research supports the use of telehealth as an effective method of enhancing access to care and building efficiencies.

Aims/Objectives: To evaluate access to care, effectiveness, financial impact, and experience after implementing telehealth as a means of communicating with living donors.

Methods: Utilizing a pretest-posttest design, an analysis was performed among medically cleared donors evaluated in-person between January 1, 2019 to December 31, 2019 (Control Group; N=64) and donors evaluated via telehealth (Zoom®) between January 1, 2021 to …

Implicit Bias Training: Improving Racial/Ethnic Disparities In Maternal Care, Marilyn Mapp

Doctor of Nursing Practice Projects

Background: Racial and ethnic disparities persist in the United States leading to adverse maternal outcomes. Nationally, the maternal mortality rates in black women are two to three times higher than white women. Implementing implicit bias training, recommended by the Council on Patient Safety in Women’s Health, is a key intervention that may help to reduce these disparities.

Objectives: This quasi-experimental/mixed methods project evaluated the effectiveness of training on implicit bias to increase awareness of implicit bias among a convenience sample of registered nurses in labor and delivery and postpartum units at two community hospitals.

Methods: Quantitative data was analyzed with …

Does The Use Of Home-Based Continuous Glucose Monitoring Devices In Adults With Diabetes Mellitus Improve Hemoglobin A1c Levels? An Integrative Review, Ophelia Dionne Gelispie Ansari

Doctoral Dissertations and Projects

The prevalence of diabetes continues to rise, but patients’ ability to obtain and maintain glycemic control remains a challenge. In 2017, complications from diabetes resulted in over $300 billion expenditures in lost productivity and medical costs. The nation’s approach to addressing this problem starts with acknowledging the benefits that continuous glucose monitoring (CGM) as an adjunct intervention could change the trajectory of both diabetic care outcomes and the national expenditures associated with poor glycemic control, which leads to the destruction of other cells such as those found in the heart, eyes, and kidneys. Moreover, CGM use has been associated with …

A Community Educational Intervention To Improve Firearm Safety Behavior In Families, Elizabeth G. Choma Msn, Rn, Cpnp-Pc

Doctor of Nursing Practice Projects

Background: Every day in America children, are injured or killed from the accidental shooting of firearms. Additionally, few households with children report storing all guns unloaded and locked up. Recent evidence supports education on safe firearm storage as an effective intervention in promoting firearm safety in families with children. However, Pediatric healthcare providers often do not have enough time for firearm education during well visits.

Objective: This Quality Improvement (QI) project aimed to use an educational intervention with statistics on firearms in children and implemented the Asking Saves Kids (ASK) campaign to assess and improve firearm safety behaviors in families …

A Certified Nurse Program: Mitigating Barriers To Certification, Kymberlee Cox Msn, Rn, Npd-Bc, Pccn-K

Doctor of Nursing Practice Projects

Background: Certification recognizes a nurse's specialized knowledge, skill, and expertise. It has been linked to positive patient, nurse, and organizational outcomes. Recognizing these advantages, the nursing department set a goal to increase certification rates. However, perceived barriers to certification existed, and rates remained unchanged. A program was needed to overcome these obstacles.

Aims/Objectives: To develop and evaluate a Certified Nurse Program that addresses the perceived barriers to certification by proactively supporting, preparing, and recognizing nurses who pursue and maintain a specialty certification.

Methodology: A 200-bed Maryland suburban hospital adopted the program. Initiatives for certification support, preparation, and recognition were implemented. …

A Telehealth Blood Pressure Education Program On Hypertension Knowledge, Selfcare, And Behavior, Cheynnie N. Burnett Msn, Aprn, Fnp-C

Doctor of Nursing Practice Projects

Background: Hypertension poses a significant risk for morbidity and mortality. Regular blood pressure monitoring, medication compliance, and/or lifestyle modifications have shown to improve control. Digital communication in healthcare, such as telemedicine provides patients and primary care offices an opportunity to improve access to care and education.

Objectives: This Quality Improvement (QI) Project aimed to answer the question: In adult patients with a diagnosis of hypertension, what is the effectiveness of implementing an evidence- based telehealth blood pressure management program in a primary health care setting, when compared to baseline, on blood pressure knowledge, management, and self-care over a nine- week …

The Impact Of Mentorship On Nurses’ Level Of Self-Efficacy And Motivation To Pursue Board Leadership Positions, Amy K. Mccarthy Msn, Rnc-Mnn, Ne-Bc

Doctor of Nursing Practice Projects

Background: Nurses comprise the largest component of the healthcare workforce and possess a unique understanding of healthcare operations and patient care. On average, the proportion of nurses serving on hospital boards range from 2 to 6%, with the proportion of physicians averaging 20%. Over the last decade, much attention has been placed on emphasizing the importance of a nurse’s presence on boards. Despite these initiatives, nurses continue to display an overall hesitancy towards board service.

Objectives: The aim of this project was to implement an evidence-based mentorship program to address barriers to board leadership and increase overall self-efficacy and motivation …

Implementation Of A Standardized Handoff Tool For The Transition Of Care Of Adult Liver Transplant Patients, Suzanne Robertazzi Msn, Anp-Bc

Doctor of Nursing Practice Projects

Background: The transfer of care of the adult liver transplant patient from the inpatient to the outpatient setting has increased in complexity and has the potential to lead to errors and adverse events.

Objective: This pre-post design quality improvement project implemented a hand-off communication tool to improve adult liver transplant patient outcomes when transitioning from the inpatient to outpatient setting.

Methods: The hand-off tool was based on Illness severity, Patient summary, Action list, Situation awareness, and Synthesis (I-PASS). An EMR chart review was completed on discharged liver transplant patients 3 months (N=28) prior and 4 months (N=36) after I-PASS implementation. …

A Whole-Food Plant Based Diet And Its Effects On Cardiovascular Disease, Meredith A. Childress

MSN Capstone Projects

The purpose of this paper and benchmark study is to present evidenced-based data regarding the impact diet choices have on heart disease and how adherence to a whole food plant based (WFPB) diet compared to a Western diet affects cardiac disease. The PICOT question being asked for this change project is as follows: In adults with history of cardiac disease (P), how does adherence to a whole-food plant-based (WFPB) diet (I) compared to the Western diet (C) impact outcomes associated with coronary artery disease (CAD) (O) over three months (T)? A search of evidenced-based literature was conducted to determine the …

Community Isolation Project, Natalie M. Danhof, Lydia Santucci, Abigail Dempsey, Nathaniel Navarro, Ivy Mills, Samantha Thompson

Nursing Leadership in Community Engagement Projects

Introduction

The authors of this summary are nursing students at Seattle Pacific University, and the project goal is focused on understanding feelings of isolation in elderly communities and whether fostering social activities, such as Bingo, would improve social interaction between residents in this community.

For the past two years, the COVID-19 pandemic has altered various aspects of social interaction. From masking to social distancing, societal norms and expectations evolved in a manner that promoted isolation and minimal interaction to inhibit the spread of Covid infection between individuals. Of the general populace, the most vulnerable and at risk for infection are …

The Measles-Mumps-Rubella Vaccine And Parental Hesitancy: The World’S Unspoken Pandemic, Kayla James

Senior Honors Theses

The Measles-Mumps-Rubella vaccine (MMR) is a proven necessity for the prevention of measles, mumps, and rubella, which possess severe and possibly life-threatening complications. However, the means in which these vaccines are produced, mandated, or scheduled raise certain concerns within the medical and pharmaceutical consumer community. In fact, there are various communities around the globe that willfully choose to refuse the MMR vaccine, along with many other pediatric vaccinations, resulting in diminished vaccination rates and risk of possible outbreak of any of these three diseases. With this impending threat on the rise, it is necessary to engage in research to best …

The Anxiolytic Effects Of Aromatherapy On Preprocedural Anxiety: An Integrated Review, Rebekah Smith

Senior Honors Theses

Anxiety before procedures can negatively impact patients by increasing cortisol levels which delays wound healing and increases infection risk, increasing pain and sedation medication needs, and increasing hospitalization time. This review was conducted to find how inhaled essential oils affect pre-procedural anxiety of adults in acute care settings. Nine databases and some gray literature were searched within the past ten years, and documented using the PRISMA flow chart. Ten articles fitting the inclusion criteria were retrieved. Nine of the articles found a significant difference between the aromatherapy group and control group and pre- and post- intervention anxiety scores, and none …

Current Targeted Interventions For Adult Patients With Comorbid Obesity And Depression: An Integrative Review, Meredith Lawson Parnell

Doctoral Dissertations and Projects

Obesity and depression share a bidirectional relationship when they exist as comorbidities in addition to individually posing complex public health challenges. Evidence from recent years suggests that there is a benefit to treating these illnesses with an integrated approach when they co-occur, but no current clinical guideline exists for this approach. The purpose of this integrative review is to synthesize existing literature and report current interventions targeting the management of comorbid obesity and depression in adults. The Whittemore and Knafl methodology for integrative review is the framework used to conduct this synthesis. A systematic search was conducted of nine computerized …

Exploring Relationships Between Depression Self-Stigma And Trust In Primary Care Provider On Willingness To Seek Help, Tana Karenke

Dissertations (1934 -)

Depression is a mood disorder characterized by persistent feelings of sadness and/or loss of interest that effects an individual’s ability to carry out day-to-day activities. Depression can diminish one’s social functioning, interpersonal relationships, personal care, and work productivity. Despite the availability of various treatments for depression, roughly 34% of people suffering from depression symptoms do not seek treatment. Significant barriers for seeking help for depression symptoms include the stigma of mental illness and a lack of trust in healthcare providers; however, there is a paucity of research exploring the relationship between mental illness stigma and the role of trust in …

Genome-Wide Identification, Expression Pattern And Sequence Variation Analysis Of Snrk Family Genes In Barley, Jiangyan Xiong, Danyi Chen, Tingting Su, Qiufang Shen, Dezhi Wu, Guoping Zhang

Publications

Sucrose non-fermenting 1 (SNF1)-related protein kinase (SnRK) is a large family of protein kinases that play a significant role in plant stress responses. Although intensive studies have been conducted on SnRK members in some crops, little is known about the SnRK in barley. Using phylogenetic and conserved motif analyses, we discovered 46 SnRK members scattered across barley's 7 chromosomes and classified them into 3 sub-families. The gene structures of HvSnRKs showed the divergence among three subfamilies. Gene duplication and synteny analyses on the genomes of barley and rice revealed the evolutionary features of HvSnRKs. The promoter regions of HvSnRK family …

Remote Vascular Interventional Surgery Robotics: A Literature Review, Yang Zhao, Ziyang Mei, Xiaoxiao Luo, Jingsong Mao, Qingliang Zhao, Gang Liu, Dezhi Wu

Publications

Vascular interventional doctors are exposed to radiation hazards during surgery and endure high work intensity. Remote vascular interventional surgery robotics is a hot research field, in which researchers aim to not only protect the health of interventional doctors, but to also improve surgical accuracy and efficiency. However, the current vascular interventional robots have numerous shortcomings, such as poor haptic feedback, few compatible surgeries and instruments, and cumbersome maintenance and operational procedures. Nevertheless, vascular interventional surgery combined with robotics provides more cutting-edge directions, such as Internet remote surgery combined with 5G network technology and the application of artificial intelligence in surgical …

2022 Spring Newsletter, Morehead State University. Nursing Department.

Nursing Department Publications Archive

2022 Spring Newsletter of the Department of Nursing at Morehead State University.