Nursing Commons^™

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Determining The Impact Of Mindfulness Activities To Increase Joy In Work And Decrease Burnout: An Integrative Review, Kimberly Gleason Bogart

Doctoral Dissertations and Projects

This integrative review aims to evaluate whether mindfulness effectively increases joy in work and decreases nursing burnout. A lack of joy leads to feelings of burnout and negatively affects nurses and their desire to leave the profession. Nursing is often accompanied by intense emotional and physical demands that can lead to job dissatisfaction, anxiety, and stress. Burnout diminishes the quality of care and negatively impacts nurses’ well-being. This integrative review aims to explore mindfulness interventions to increase joy within nursing and potentially alleviate burnout. Drawing upon existing literature, this paper examines various mindfulness interventions and factors contributing to burnout among …

Development Of An Endometriosis Toolkit To Support Clinicians In Providing Quality Care For Women, Rachel Hasbun

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.

Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.

Methods: …

Inservice Education: Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: In pediatric cancer patients, comprehensive treatment and its side effects, such as fever and neutropenia (FN), significantly impact physical and emotional well-being. Prompt evaluation and treatment of FN are crucial to prevent complications. Proper training of parents in preventing, recognizing, and managing low-grade fever and administering antibiotics at home or outpatient settings is essential for positive outcomes.

Local Problem: A multidisciplinary pediatric cancer treatment center in Northern California.

Methods: A pre- and post-assessment evaluation was conducted to evaluate the knowledge acquisition of nurses after an educational intervention.

Intervention: This Doctor of Nursing Practice (DNP) project aimed to enhance …

Undergraduate Baccalaureate Nursing Student Knowledge And Attitudes Towards Neonatal And Pediatric Pain Management Practices, Jordan Lee Slowik

Doctoral Dissertations and Projects

Research has indicated that pain management practices amongst registered nurses is inadequate across all age groups; however, it is frequently noted that children receive less analgesia in comparable situations than adult clients leading to harmful and costly consequences. There is a distinct gap in nursing educational research understanding nursing student knowledge and attitudes towards neonatal and pediatric pain management practices. Using a convenience sample from a private, Christian-based university in the southeastern United States, this study used a quasi-experimental, one-group pretest/posttest design to understand the impact of elective nursing courses on undergraduate baccalaureate nursing student knowledge and attitudes towards neonatal …

The Experiences Of Alaska Native Students' Decision To Enter Nursing School: A Transcendental Phenomenological Study, Denise Michelle Gilliland

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenology study was to examine the lived experiences of Alaska Native students’ decisions to enter nursing school, thus choosing nursing as a career. The increased recruitment of Alaska Natives into nursing is imperative. According to the research, a direct association exists between increasing the number of minority nurses and decreasing health inequities. Despite the demand, only a small number of Alaska Native students continue to enroll in nursing programs in Alaska. The theories guiding this study were Ryan and Deci’s self-determination theory and Lowe and Struthers’s theory of nursing in Native American culture. They provided …

Let's Talk About Sex & Prep: District 2 Does!, Chrissa M. Shaffer

Georgia Public Health Association Annual Meeting & Conference

Defining what a PrEP Service Program entails and how it could benefit your district or county health center. Discussing methods that have been used to set up PrEP Services within a district – including training, resources, and promotion. Identifying the challenges and working through them. Reviewing the results of the PrEP Services over the past year, and the ongoing goals to encourage and increase our PrEP Services.

Reducing Delirium In Post-Surgical Patients Through Pre-Operative Risk Assessment Screening: A Policy Option, Skye Porter Berg Msn, Fnp

Doctor of Nursing Practice Final Manuscripts

One of the major complications and reasons for prolonged stay amongst patients who undergo surgery is related to the occurrence of hospital associated delirium. Unfamiliar environment, previous comorbidities, age and anesthesia can alter and affect cognitive status in the general population. While there is substantial evidence previously listing high risk patients through demographics as well as prior medical history, this study collectively gathers information based upon prior evidence-based practice data to determine the benefit of prescreening patients through use of a predictive indicator tool. Based on the literature review and inclusion data gathered from fifty patients undergoing surgery, it was …

Implementing Animal-Assisted Therapy During Psychiatric Intakes, Rebecca Dorne

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based project is to determine if Animal-Assisted Therapy (AAT) causes improvements in veterans’ feelings of anger, anxiety, depression, and suicidality in the acute psychiatric setting during psychiatric evaluations. The project aims to provide veterans with an additional way to experience short-term relief from symptoms while discussing their symptomology with mental health providers.

Background: The prevalence of depression is 20% higher in veterans than in that of the general population. Similarly, it has been shown that 23% of all veterans using VA care have had PTSD at some point in their lives. In the Psychiatric Emergency …

Improving Treatment Adherence Of Chronic Disease Management In Patients Presenting To The Interventional Pulmonary Perioperative Services With Telephone Follow-Ups, Victoria Dao, Desiree Camille Nanat

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose of Project: The purpose of this evidence-based practice (EBP) project was to review research-based evidence systematically and to implement evidence-based change in practice in the clinical setting. The goal is to improve treatment adherence in patients with obesity, hypertension (HTN), type 2 diabetes mellitus (T2DM), and obstructive sleep apnea (OSA) by providing telephone follow-ups within 30 days post-perioperative discharge.

Background: Obesity, HTN, T2DM, and OSA continue to pose significant challenges to the United States healthcare system. Nonadherence to prescribed management of these chronic diseases is prevalent among patients presenting to the perioperative department of a regional academic hospital …

Improving Healthcare Workers’ Biohazardous Spill Safe Handling Skills, Zeina Mhanna, Ahmad Tassi

BAU Journal - Health and Wellbeing

All healthcare workers (HCWs) are exposed to biohazardous material. Biohazardous material may come in the form of spills, posing a risk of infection to (HCWs) who are not trained on how to safely handle them. While international guidelines recommend training HCWs on how to safely handle biohazardous spills in order to improve their skills, there are no studies that tackled this recommendation. The aim of this study is to improve HCWs’ biohazardous spill safe handling skills through training, and to evaluate the association between the HCWs’ improvement level and demographical characteristics. The study was conducted in a Southern Lebanese hospital …

Influence Of Social Media On Mothers’ Decision-Making Regarding Vaccinations, Wendy Michele Patterson

Walden Dissertations and Doctoral Studies

This study involved determining why mothers hesitate to vaccinate their children and where they get their information about vaccinations. This descriptive qualitative study guided by the health belief model explored the influence social media has on mothers’ perceived barriers to vaccinating their children. A descriptive qualitative approach was used, and one-on-one audio interviews were conducted via Zoom or in person with 19 participants. Participants were mothers 19 or older, had children between zero and 18, made medical decisions for their children who resided in their household, and sought information about vaccinations via healthcare providers, social media platforms, friends, or family. …

The Lived Experiences Of High-Performing Black Male Students With Advanced Placement Courses, Griselda Almonte-Delgado

Seton Hall University Dissertations and Theses (ETDs)

Black male students are underrepresented in Advanced Placement (AP) courses. Studies on the perspective and experiences of high performing Black male students with Advanced Placement (AP) is limited. Available research indicates that high performing Black students are enrolled at half the rate of White students both nationally and locally in Advanced Placement (AP) courses (Dept. Of Civil Rights, 2021). Research uncovers multifaceted factors influencing enrollment, ranging from personal motivation to systemic barriers. To qualitatively address this dissonance, this research used Attribution Theory as its framework to examine the lived experiences and perceptions of eight high performing Black male students from …

The Perceptions Of A Nurse-Led Telehealth Discharge Program On Continuity Of Care For Pediatric Rheumatology Patients, Adrienne Ramirez

Doctoral Projects

When pediatric rheumatology patients are discharged from a hospital, they are given a complex discharge plan which involves responsibilities in self-managing their care at home. This creates an overwhelming time for patients and families who may have questions or concerns during this time. In order to address this care gap and provide continuity of care, this quality improvement project implemented a nurse-led telehealth discharge visit intervention to 15 pediatric rheumatology patients during the transition from hospital discharge to outpatient care. This quality improvement (QI) project also aims to describe the patients’ perceptions of the nurse-led telehealth discharge intervention on continuity …

The Impact Of Electronic Health Record Unintended Consequences On Quality Of Care Within A High Complexity Healthcare Organization, Joetta Powell

ATU Theses and Dissertations 2021 - Present

“Unintended consequences are unexpected, and unwanted outcomes that can limit the value of EHR implementation and adversely affect quality of care and patient safety” (Lee & Kang, 2021, p. 898). Few organizations have redesigned the EHR to improve usability to mitigate potential patient safety concerns. This study aims to identify unintended consequences in patient care workflows and determine educational needs related to EHR usability. A mixed method approach was used to investigate unintended consequences in deidentified patient safety reports submitted Jan 1, 2020, through December 31, 2023. The data was analyzed to identify error types and educational deficits. The Acute …

Utilizing Decision Tree Implementation And Provider Education To Improve Colorectal Cancer Screening Orders: A Quality Improvement Project, Alicia Kollar

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths (Jain, et al., 2022). Healthy People 2030 objectives include reducing the CRC death rate and increasing the proportion of adults who get screened (Healthy People 2030, n.d.). According to 2021 data, only 58.7% of adults are screened with a Healthy People target of 68.3%. Healthy People states that there are effective screening tools to detect colorectal cancer early, and people are more likely to survive it (Healthy People 2030, n.d.). Purpose: This quality improvement (QI) project aims to implement an …

Strokes Of Excellence And Opportunity: A Program Evaluation Analyzing Emergency Department Stroke Care In A Newly Formed Five-Hospital Health System, Joshua Adams

Doctor of Nursing Practice (DNP) Manuscripts

Stroke is a significant public health problem in the United States and globally. For patients experiencing an acute ischemic stroke, also known as “infarct” or “brain attack,” the effectiveness of treatment is extremely time dependent. This DNP Project presents a program evaluation of stroke care delivered in five emergency departments (EDs) in community hospitals in a health system newly formed through the merger of two smaller organizations. This evaluation focused on assessing the five programs’ effectiveness in delivering timely and effective care to stroke patients with the standardized performance measure door-to-needle (DTN). The evaluation also included a review of factors …

Identify And Overcome The Barriers Of Care From A Patient And Provider Perspective In Adult Patients With Type 2 Diabetes Mellitus In A Federal Qualified Health Clinic: A Quality Improvement Project, Jill Miscovich

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes is a significant healthcare issue that not only effects the United States but also has a global impact, it is costly for the workforce and to manage. Diabetes management is more complex in rural areas due to increased SDOH and barriers to care. The purpose of this quality improvement (QI) project is to identify and overcome the barriers to care from the patients and nurse practitioners’ (NPs) perspectives in adult patients with type 2 diabetes mellitus (T2DM) in a rural federal qualified health clinic (FQHC). A mixed method approach was used including qualitative and quantitative data project manager created …

Identify And Overcome The Barriers To Care From A Patient And Provider Perspective In Adult Patients With T2dm In A Rural Federal Qualified Health Clinic (Fqhc): A Quality Improvement (Qi) Project, Jill Miscovich

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes is a significant healthcare issue that not only effects the United States but also has a global impact, it is costly for the workforce and to manage. Diabetes management is more complex in rural areas due to increased SDOH and barriers to care. The purpose of this quality improvement (QI) project is to identify and overcome the barriers to care from the patients and nurse practitioners’ (NPs) perspectives in adult patients with type 2 diabetes mellitus (T2DM) in a rural federal qualified health clinic (FQHC). A mixed method approach was used including qualitative and quantitative data project manager created …

Barriers, Facilitators, And Competencies In Advocating For Adults With Intellectual Disabilities With Health Disparities, Carol Adams

Electronic Theses and Dissertations

Background: Nurses working in the specialty of intellectual disabilities are positioned to advocate for individuals with intellectual disabilities and other health disparities. This study explored nurses’ perceived competencies, barriers, and facilitators when advocating for improved health status in adult patients with intellectual disabilities.

Methods: Twenty-five nurses working in the specialty of intellectual disabilities were interviewed using semi-structured interviews, and the data were analyzed using thematic analysis.

Results: Barriers identified in advocacy were: Funding, Communication, Negative Perceptions and Misperceptions, Lack of access, and Diagnostic Overshadowing. Nurses were also facilitated in advocating for improved health status in people with intellectual disabilities. Facilitators …

School Nurses And Administrators Perceptions Of School Preparedness: A Focused Ethnography, Deborah Horton

Electronic Theses and Dissertations

Background: Disasters are dangerous for schools where many children are located in one area. Children were significantly impacted by a biological incident during the 2009 H1N1 influenza pandemic, and more recently the COVID-19 pandemic. Research is needed to determine the values, perceptions, and beliefs of school disaster preparedness through a cultural lens.

Methods: A focused ethnography was used to interview school administrators and nurses from April-December 2022 to explore and understand the unique culture of school disaster preparedness. Data was analyzed according to Leininger’s Four Phases of Data Analysis.

Results: Twenty-four participants from K-12 public schools were interviewed resulting in …

Impact Of An Electronic Human Papillomavirus Vaccination Catch-Up Module For Women With Criminal-Legal System Involvement, Shawana Moore

Electronic Theses and Dissertations

Introduction: Cervical cancer can often be prevented with targeted strategies such as Pap smear screenings and the human papillomavirus (HPV) vaccination, now also recommended for those aged 27-45 who have not received the vaccine previously. However, women involved in the criminal-legal system often miss out on primary and secondary prevention measures and are at increased risk for the development of cervical cancer caused by HPV. Purpose: The purpose of this study was to examine the feasibility and acceptability of an electronic HPV catch-up module for women in the criminal-legal system aged 27-45. The study, guided by the Health Belief Model, …

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands

Graduate Theses, Dissertations, and Capstones

This project aimed to implement a process improvement program at the Louisville campus of Galen College of Nursing to improve the mental health support for nursing students through the training of Clinical Instructors (CIs) in using adult Mental Health First Aid (MHFA) and the ALGEE actions described within that program.

Improving Access To Mainehealth Care At Home, Amanda Kunkel, Mhcah Intake Department, Mhcah Scheduling Department, Mhcah Clinical Leadership Team

Operations Transformation

It is known that there are capacity limitations at MaineHealth Care at Home caused by a decrease in staffing. This leads to limited availability of home health services to patients in the community and can also contribute to increased length of stay for patients in acute care hospitals. MaineHealth Care at Home needs a way to measure current capacity to accept referrals and improved systems for communicating with referral sources.

Christian-Based Health Promotion Program, Amber Vail

Doctor of Nursing Practice Scholarly Project

Chronic diseases are on a rise and placing hardship on healthcare in the United States. Regular physical activity and consumption of fruits and vegetables have proven to have health benefits related to decreasing chronic disease and improving the management of chronic diseases. A majority of the United States adult population do not meet the guidelines that are set forth by the CDC that will have a positive effect on the reduction of chronic diseases.

The purpose of this six-week Christian-based health promotion program was to improve the health of individuals in the congregation by increasing each individual’s weekly physical activity …

From Crisis To Aftermath: The Role Of Nursing Professional Development Educators During The Covid-19 Pandemic: A Realist Case Study, Kimberly Kanner

Theses and Dissertations

The purpose of this qualitative, realistic inquiry case study was to examine and understand the experiences of NPD educators as they assisted new graduate nurses transitioning into clinical nursing practice during the COVID-19 pandemic in acute care hospitals in the state of New York. Moreover, this research study sought to understand how the COVID-19 pandemic brought about changes to the NPD educator's role and their ability to assist new graduate nurses transitioning into clinical practice post-pandemic. The sample included NPD educators from acute care hospitals in the state of New York. Data collection included semi-structured interviews and document collection. The …

Low Vitamin B12: The Need For Updated Provider Education, Tracy Coltharp

Doctor of Nursing Practice Scholarly Project

Vitamin B12 deficiency is a notable clinical problem with multi-factorial risk factors and a multitude of clinical manifestations. It is associated with polyglandular autoimmune syndromes, some familiar and some lesser well known. The specific aim of this scholarly project was to evaluate whether education aimed at providers such as nurse practitioners, nurse practitioner students, physician assistants, and physicians regarding updated diagnostic criteria for vitamin B12 deficiencies as well as associated diseases, specifically autoimmune gastritis, and pernicious anemia, increased their knowledge and ultimately improved clinical practice. The project utilized a pre-test/post-test design with education provided in between. There was an improvement …

The Effect Of Education Path And Nursing Specialty On Knowledge And Attitude Survey Regarding Pain Scores, Justin Cope

Doctor of Nursing Practice Scholarly Project

Pain is reported as the number one fear of patients, and has been shown to stop patients from seeking necessary medical treatment in a timely manner. Therefore, it is important that health care professionals be able to properly assess and treat pain. One area not previously studied is how degree path affects knowledge acquisition.

The purpose of this study is to determine the effect of structured education and clinical experience on general pain knowledge between traditional and non-traditional Bachelors of Science in Nursing students. Participants of this study include RN-BSN students and pre-licensure BSN students who have completed the Adult …

Dnp Final Report: Central Line Dressing Change Regimen To Decrease Central Line-Associated Bloodstream Infections, Ann Campbell

DNP Final Reports

Central line associated bloodstream infections (CLABSI) are dangerous and costly occurrences in healthcare facilities. This evidence-based project's purpose is to implement interventions to reduce CLABSIs in a healthcare facility that has higher than the national average of reported cases. The practice problem PICOT question is: In inpatients with indwelling central venous access devices at the facility, (P) how does implementation of evidence-based guidelines for central line dressing changes every seven days and as needed (I) compared to the current practice of dressing changes on Fridays (C) affect CLABSI rates over a three-month period (O). The body of evidence obtained in …

Enhancing The Culture Of Safety Among Hospital Personnel By Implementing A Just Culture Program: A Quality Improvement Project, Lawson Stuart

Doctor of Nursing Practice (DNP) Manuscripts

Objectives

The purpose of this study was to assess employee perceptions of a healthcare organization’s existing climate of psychological safety regarding reporting patient care errors or near-miss events. Based on data obtained from the use of a valid and reliable survey tool, a plan was developed for the introduction and implementation of Just Culture throughout a large multi-hospital healthcare system.

Methods

Employee perceptions of the organization’s culture and current barriers to improving patient safety were identified by administering the JCAT survey to a population of 25,893 frontline staff, middle leaders, and senior leaders (clinical and non-clinical) at 26 separate hospitals …