Nursing Commons^™

New Approach To Professional Governance In Ambulatory, Brittney Saldierna, Katelyn Tinkey, Diana Sarmiento

2024

INNOVATION

Shared Governance Committees have involved frontline staff in driving change for many years. However, they often involve significant input from leaders, making frontline staff feel like their opinions don't matter as much. Professional Governance Committees emphasize that frontline staff should be the primary drivers of change without significant influence from leaders. Leaders should focus on removing barriers to the frontline staff's vision and ensuring that all changes comply with policies and regulations.

This Ambulatory System has created a unique structure in which the Ambulatory Council (AC) is the overarching structure for nine other councils. These councils meet monthly and …

High Reliability Pediatric Heart Centers: Always Working Toward Getting Better, Andrea Torzone, Alexandra Birely

2024

QUALITY

Background
As provision of care reaches a new complexity in pediatric cardiology, programs are called upon to evaluate how they can bring their teams into the future of pediatric cardiac care. High reliability principles support high-quality care and improve outcomes, thus should be embraced to guide continuous improvement. Although much has been written about high reliability in healthcare, it has not been explored within pediatric heart centers. The purpose of this review is to examine high reliability through the lens of a contemporary pediatric heart center, elaborating on key concepts and proposed considerations for maintaining a high reliability heart …

Management Of Failure To Thrive In An Infant With Unrepaired Congenital Heart Disease: A Case Study On Energy And Nutrient Dense Formula, Alexandra Birely, Sarah Dundas

2024

EBP

Introduction: Infants with congenital heart disease (CHD) are at risk for malnutrition and failure to thrive (FTT). Preoperative nutritional status impacts postoperative outcomes; thus nutrition should be optimized before surgery. Unrepaired infants have higher energy requirements & fluid restrictions, posing challenges in promoting growth for surgery. Energy and nutrient-dense formula has successfully treated FTT in the postoperative phase, however, evidence is limited in unrepaired infants.

Case Description: The case presented is a 4-month ex-36 week infant, past medical history significant for CHD with large ventricular septal defect (VSD), atrial septal defect (ASD), pulmonary stenosis and solitary kidney. Following discharge …

Rise Of The New Grad: Early Engagement Of New Graduate Nurses In Professional Governance, Annie Tolliver, Katie Fields

2024

INNOVATION

Background: Traditionally, new graduate nurses (GNs) are advised to gain experience before participating in Nursing Professional Governance (NPG). NPG is a structure that empowers nurses to be decision-makers regarding the nursing practice environment. We identified GNs had minimal knowledge of and engagement in NPG. An innovative process was developed to involve GNs in NPG, challenging the traditional approach.

Literature: Substantial evidence supports that nurses engaged in NPG are empowered to make decisions, leading to better patient outcomes and increased professional satisfaction. Research shows GNs’ dedication and professional satisfaction are tied to their ability to embed into the organizational culture …

Owning Your Practice Through Evidence-Based Practice (Ebp) - Transformational Leadership Strategies That Create The Foundation For Ebp Enculturation, Sara Moore, Kathleen Ellis, Zara Sajwani-Merchant, Lindsey Patton

2024

INNOVATION

Background: Nursing Research and Evidence-Based Practice (NREBP) is central to advancing nursing science and integrating nursing practices supported by scientific inquiry to improve health outcomes and quality of care^1,4. The gap between what nurses know and what they do can have life-altering consequences^2,7 . The degree to which nurses base their practice behaviors on research, EBP competence, and use of EBP skills is sub-optimal and is directly influenced by organizational and institutional barriers³. Common barriers to implementing EPB behavior change include organizational culture, leadership, networks and communication, resources, evaluation, monitoring and feedback, and availability …

Midline Catheter Implementation: Expanding Vascular Access Options In A Level Iv Nicu To Decrease Vascular Injury, Kymeyone Lanehart, Rebecca Palmer, Jeri Tidwell, Sushmita Yallapragada, Courtney Campbell, Lebanon David, Katie Doerge

2024

EBP

Background: PIV catheters are the most placed device in the NICU requiring frequent attempts, with a brief duration due to complications which indicate removal before completion of treatment. PIVs used for treatment have a patient safety risk of PIVIE; the severity can be mild, moderate, or severe depending on the swelling and tissue damage. PIVIE rates are one of the patient quality outcomes and are increasing in the NICU. Considering the increased risks of long-term consequences from tissue injury associated with PIVs, MCD may improve quality and patient outcomes.

Problem: PICOT question: (P)For eligible neonates in a level IV …

Optimized Pain Management Protocol For Pediatric Needlestick Procedures: Boosting Team Coordination And Pain Relief, Dhanu N. Bhandari

2024

EBP

PICOT Question:Among clinical staff in the Integrated Therapy Unit (ITU), how does the implementation and education of a standardized set of topical anesthetic agents affect staff consistency with the new pain management procedure over six months compared to existing inconsistent practices?

Background:Effective pain management during pediatric needlestick procedures is critical but often neglected, leading to immediate distress and long-term issues like needle phobia. Research shows that proper pain management not only reduces pain but also improves patient satisfaction and clinical outcomes. However, inconsistent use of strategies like topical anesthetics has hindered optimal care. This project aimed to …

Administration Of Naxitamab In High-Risk Neuroblastoma Patients To Manage Adverse Reactions, Lauren Brown, Nikki Marshall, Diamond Wright

2024

INNOVATION

Neuroblastoma is the most common extracranial solid tumor in children with approximately 700 cases diagnosed yearly. Children treated with traditional therapies experience a recurrence rate over 50%, increasing the chances of poor clinical outcomes. Integrating anti-disialoganglioside-2 (GD2) monoclonal antibodies like Naxitimab have significantly improved patient outcomes. However, there is no standardized process between pediatric institutions to administer the drug while managing adverse drug reactions. Naxitimab received accelerated approval from the US Food and Drug Administration for children over age one with relapsed/refractory high-risk Neuroblastoma. Approximately half of the patients receiving Naxitimab encountered acute adverse events (AEs). Different institutions manage …

Exploration Of Decedent Care Practices Among Pediatric Hospitals In The United States, Mayra Garcia, Kim Mccarthy, Kiele Samuel, Kathleen Ellis, Lisa Jones, Joe Don Cavender, Ryan Campbell, Chelsea Reynolds, Jesse Leos, Pauline Chen

2024

RESEARCH

Purpose:
Pediatric deaths in hospitals profoundly affect both staff and families, underscoring the need for clear decedent care processes and specialized training to navigate emotional and procedural challenges. Cooling rooms and reflection spaces, which provide families with more time for memory-making and help ease the emotional burden of separation, have been shown to offer significant support. However, these facilities are less common in the U.S., highlighting the necessity for further research in this area. The purpose of this study was to explore the decedent care (DC) practices in pediatric hospitals in the United States.

Methods:
Participants were recruited via …

From Identification To Action: Nurses Respond To Human Trafficking, Misty Daugherty, Jill Hanks, Alison Kell, Annie Tolliver, Katie Fields, Lily Velez

2024

INNOVATION

Background: In 2022, nurses from a pediatric healthcare system hosted a Human Trafficking Conference to educate healthcare providers on the identification of human trafficking victims. In post-conference surveys, participants reported a gap in their ability to respond once a human trafficking victim was identified. The conference planning committee reconvened in 2023 to address this gap and shifted from a didactic presentation to application and simulation.

Purpose: Research shows in our home state, there are about 313,000 people being trafficked, up to 50% of them being youth. It is estimated that up to 88% of human trafficking victims encounter healthcare …

The Use Of Storybook Implementation For Patient Education Tools, Jennifer Brown

2024

EBP

Practice Problem: For children with growth delay and their parents, how can implementation of storybooks with images, compared to disease specific handouts, increase understanding and knowledge of the disease and treatment as well as decrease anxiety? It was identified that parents and patients coming to the Endocrine Clinic for growth delay, did not always fully understand the reasons for the growth evaluation or causes of growth delay.

Literature/Evidence: Literature was retrieved, appraised, and synthesized to define best practices to create storybooks. Best practices included, using storybooks that include images, co-creation with intended audience. Using storybooks for patient education …

Relationship Between Opioid Treatment And Nonpharmacological Chronic Pain Management Interventions And Perceived Effectiveness Of Managing Chronic Pain In African American Adults, Bona Eze

Walden Dissertations and Doctoral Studies

Chronic pain impacts all areas of life for most Americans, but the issue is particularly salient among African Americans (AAs) as they face adverse pain outcomes. There is little understanding of pain management strategies used by AAs to inform pain management recommendations. The purpose of this study, guided by the COM-B model and biopsychosocial theory, was to determine if there were a relationships between opioid treatment and perceived effectiveness of managing chronic pain in AA adults who are 18 years and older as well as between nonpharmacological interventions (physical therapy, chiropractic care, talk therapy, self-management program, yoga, massage) and perceived …

Comparing Costs And Predictors Of Low-Value Healthcare Service Use Among Primary Care Nurse Practitioners In The Southwest United States, Sara B. Nugent

Nursing ETDs

Low-value healthcare services (LVHSs) are unsupported by current evidence, associated with harmful patient outcomes, and equate to over $100 billion in wasteful spending annually. The aims of this descriptive, comparative study were to establish baseline prevalence and costs associated with LVHS use among primary care nurse practitioners (NPs), and to test the influence of different geographical regions and patient populations. A secondary data analysis of the Merative™ MarketScan® 2021 databases was conducted. LVHS prevalence was lower or fairly equal to that of other studies, and direct claim costs were very-low cost. Extremely high low-value lumbar radiographic imaging claim costs were …

Uncovering The Complexity Of Perinatal Polysubstance Use Disclosure Patterns On X: Mixed Methods Study, Dezhi Wu, Hannah Shead, Yang Ren, Phyllis Raynor Phd, Aprn, Pmhnp-Bc, Youyou Tao, Harvey Villanueva, Peiyin Hung, Xiaoming Li, Robert G. Brookshire, Kacey Eichelberger, Constance Guille, Alain H. Litwin, Bankole Olatosi Ph.D.

Publications

BACKGROUND: According to the Morbidity and Mortality Weekly Report, polysubstance use among pregnant women is prevalent, with 38.2% of those who consume alcohol also engaging in the use of one or more additional substances. However, the underlying mechanisms, contexts, and experiences of polysubstance use are unclear. Organic information is abundant on social media such as X (formerly Twitter). Traditional quantitative and qualitative methods, as well as natural language processing techniques, can be jointly used to derive insights into public opinions, sentiments, and clinical and public health policy implications. OBJECTIVE: Based on perinatal polysubstance use (PPU) data that we extracted on …

How Do Older Adults Define A Good Death? A Scoping Review, Ellen L. Csikai, Quentin R. Maynard

Midwest Social Sciences Journal

A scoping literature review of the concepts of ‘good death’ and ‘dying well’ among older adults was conducted. The purpose was to identify aspects that older adults specifically considered important in defining a ‘good death’. The search revealed five articles published between 2005 and 2019 that met inclusionary criteria for the review. Primary among the views of the older adults in these studies of a ‘good death’ was the desire to avoid being a burden to families; done so by dying pain-free/peacefully (preferably in sleep) and preparing in advance by involving family in decisions and funeral/estate planning. Family support throughout …

I Don't Know How To Live Real Life Sober'-Identifying Needed Supports Through The Voices Of Pregnant And Parenting People Seeking Recovery, Phyllis Raynor, Cynthia F. Corbett, Delia West, Constance Guille, Kacey Eichelberger, Alain Litwin, Ron Prinz

Publications

Pregnant and parenting people (PPP) experience complex challenges when seeking recovery from substance use disorders (SUD). Using a community-based participatory research approach, researchers partnered with PPP seeking recovery from SUD to explore supports needed in their communities. Findings are reported in adherence with the consolidated criteria for reporting qualitative research. Thirty PPP were recruited from a residential drug recovery facility in the Southeastern United States. Participant interviews were conducted in-person or virtually. PPP were asked to identify existing and needed parenting and recovery supports in their communities. Interviews were transcribed, verified for accuracy and coded using NVIVO software. Thematic analysis …

Using Interpretive Description To Facilitate Women's Contributions To Maternity Care: Experiences And Views Of Obstetric Fistula Prevention, Lydia Babatunde Bulndi, Sara Bayes, Deborah Ireson, Esther Adama

Research outputs 2022 to 2026

Background/AimsInterpretive description is a qualitative methodology that combines detailed descriptions with thoughtful interpretation. This approach is especially effective for producing practical insights and deepening the understanding of phenomena in clinical or practice-based settings. The aims of this study were to explore how interpretive description could be used to research the experiences and views of women with obstetric fistula. MethodsInterpretive description was used to explore the experiences and views of 15 purposively selected women affected by obstetric fistula. Participants were recruited via the Evangel Vesico Vaginal Fistula Centre of Bingham University Teaching Hospital. Data were collected via in-depth interviews and concurrently …

Determinants Of Quality Antenatal Care Use In Kenya: Insights From The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Angella Namulem, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Earnest Amwiine, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Provision of quality antenatal care (ANC) is important to reduce maternal and newborn fatalities worldwide. However, the use of quality ANC by women of reproductive age and associated factors remain unclear in many developing countries. Therefore, this study aimed to determine factors associated with receiving quality ANC in Kenya among women of reproductive age. We analyzed secondary data from the 2022 Kenya Demographic Health Survey, which included 11,863 women. Participants were selected using two-stage stratified sampling. Univariate and multivariable logistic regression analyses were used to analyze the data. Of the 11,863 participating women, 61.2% (95% confidence interval (CI): 59.7%–62.6%) received …

Building Confidence, Diminishing Stress: A Clinical Incivility Management Initiative For Nursing Students, Younglee Kim, Phoebe (Yeon) S. Kim, Henrietta Nwamu, Anne Lama

Nursing Faculty Publications

Objective: The aim of this study was to evaluate the effectiveness of an interactive program designed to reduce nursing students’ perceived stress and improve self-efficacy and readiness to professionally address incivility during clinical practice. Background: Incivility in clinical settings adversely impacts learners, educators, institutions, and healthcare systems, undermining safety and the teaching–learning process. Despite its increasing global prevalence, effective interventions remain largely unexplored. Methods: Our mixed-methods study, conducted from March to April 2024, involved senior baccalaureate pre-licensure nursing students (N = 35) from a California State University. The three-week, one-hour-per-week, interactive clinical incivility management program was developed through an extensive …

The Effects Of High-Fidelity Bereavement Simulation On Perinatal Nurse Attitude And Comfort With Providing Bereavement Care For Patients Experiencing Perinatal Loss, Victoria Jule Johnson

Doctoral Dissertations and Projects

Perinatal loss is a global phenomenon that requires holistic and individualized care of patients. Nurses are responsible for providing most bereavement care after the loss of a pregnancy or infant; however, nurses commonly experience a lack of education and exposure to ways to promote high-quality bereavement care, leading to nurse discomfort providing perinatal bereavement care. The purpose of the study is to examine if high-fidelity perinatal bereavement simulation is an effective method to increase nurse comfort and improve nurse attitudes toward providing perinatal bereavement care. Data was collected using a quantitative quasi-experimental one-group pretest-posttest research design using a sample of …

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

DNP Qualifying Manuscripts

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Screening, Brief Intervention, And Referral To Treatment For Pregnant Women, Rebekah Feeney

Dissertations

Abstract

Background: In the United States, 10-20% of pregnant women reported using drugs during pregnancy. Current recommendations are to screen for drug use in all patients and provide a brief intervention and referral to treatment. The purpose of this quality improvement project was to evaluate the impact of implementing a standardized screening, brief intervention, and referral to treatment (SBIRT) protocol for first-trimester pregnant patients who are seen in the obstetrical department.

Methods: The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) screening tool was administered to first-trimester pregnant women, 13-45 years of age, seen in the obstetrical department from …

Screening For Depression Post Acute Coronary Syndrome, Alyssa Graham

Dissertations

Background: Acute coronary syndrome (ACS) and depression have profound impacts on patient outcomes. Patients who experience ACS are at increased risk of developing depression, which is associated with an increased risk of death and recurrent cardiac events. The evidence following ACS events promotes routine depression screening. The purpose of this project was to identify early depression in patients 65-99 years of age who had a recent diagnosis of ACS during their hospitalization.

Methods: This quality improvement (QI) project was a prospective descriptive observational design implementing a depression screening protocol to evaluate post-ACS referrals within 7-14 days of screening from February …

Exploring Barriers To Effective Covid-19 Risk Mitigation, Recovery, And Chronic Disease Self-Management: A Qualitative Multilevel Perspective, Gayenell S. Magwood Phd, Rn, Faha, Faan, Charles Ellis, Chanita Hughes Halbert, Ebony Allen Toussaint, Jewel Scott Phd, Rn, Fnp-C, Lynne S. Nemeth

Publications

INTRODUCTION: Many research activities have focused on SARS-CoV-2 infection and subsequent COVID-19 respiratory illness during the pandemic. However, significant racial inequities emerged months after the COVID-19 pandemic began. The similarity between racial/ ethnic disparities in COVID-19 and those for other diseases raised awareness about the context for risk exposure and healthcare access. The purpose of this study is to examine social and structural determinants of health among COVID-19 survivors, carepartners, and the perspectives of healthcare stakeholders who experienced disruption during the early pandemic. MATERIAL AND METHODS: A purposive sample of interviews (n=9) and focus groups (n=10) were used to collect …

Exploring Barriers To Effective Covid-19 Risk Mitigation, Recovery, And Chronic Disease Self-Management: A Qualitative Multilevel Perspective, Gayenell S. Magwood Phd, Rn, Faha, Faan, Charles Ellis Jr, Chanita Hughes Halbert, Ebony Allen Toussaint, Jewel Scott Phd, Rn, Fnp-C, Lynne S. Nemeth

Faculty Publications

Introduction: Many research activities have focused on SARS-CoV-2 infection and subsequent COVID-19 respiratory illness during the pandemic. However, significant racial inequities emerged months after the COVID-19 pandemic began. The similarity between racial/ ethnic disparities in COVID-19 and those for other diseases raised awareness about the context for risk exposure and healthcare access. The purpose of this study is to examine social and structural determinants of health among COVID-19 survivors, carepartners, and the perspectives of healthcare stakeholders who experienced disruption during the early pandemic.
Material and methods: A purposive sample of interviews (n=9) and focus groups (n=10) were used to collect …

Effectiveness Of Simulation In The Education Of Rns Transitioning Into The Operating Room, Cortney Ann Lupo

Walden Dissertations and Doctoral Studies

RNs who are new to the operating room (OR) must gain confidence and clinical reasoning skills to care for individuals undergoing surgery. Training in the OR is stressful but using simulation for training RNs new to the OR may improve clinical reasoning and confidence. The purposes of this two group, repeated measures study, guided by National League of Nursing/ Jefferies simulation theory and Benner’s novice to expert theory, were to determine if there was a difference in (a) clinical reasoning levels of RNs new to the OR who received simulation compared to clinical reasoning levels of RNs new to the …

We All Fall Down - Fall Prevention On An Inpatient Pediatric Unit, Jennifer Watt

EBP Fellowship

No abstract provided.

Using Storybooks With Images To Improve Diagnosis Understanding And Decrease Anxiety Among Patients And Parents, Jennifer Brown

EBP Fellowship

No abstract provided.

Training Nurses To Practice Within A Wellness Model - A Rn’S Role In Using Social Determinants Of Health To Improve Patient Outcomes, Brittney Saldierna

EBP Fellowship

No abstract provided.

Remain Calm - Decreasing Perceived Stress Levels Through Implementation Of A Quiet Room, Chelsea Reynolds

EBP Fellowship

No abstract provided.