Nursing Commons^™

Whs Guidelines For The Treatment Of Pressure Ulcers: 2023 Update, Lisa J. Gould, Jenny Alderden, Rummana Aslam, Adrian Barbul, Kath M. Bogie, Mohamed El Masry, Letitia Y. Graves, E. Foy White-Chu, Amany Ahmed, Kerriann Boanca, Jessica Brash, Katie R. Brooks, Wendy Cockron, Susan M. Kennerly, Aaron K. Livingston, Jeni Page, Catherine Stephens, Velena West, Tracey L. Yap

Nursing Faculty Publications and Presentations

The major populations at risk for developing pressure ulcers are older adults who have multiple risk factors that increase their vulnerability, people who are critically ill and those with spinal cord injury/disease. The reported prevalence of pressure ulcers in the United States is 2.5 million. However, this estimate is derived from acute care facilities and does not include people who are living at home or in nursing facilities. Despite the implementation of hospital and facility-based preventive measures, the incidence of pressure ulcers has not decreased in decades. In addition to the burden of pain, infection and death, it is estimated …

Information Impact On Home-Based Palliative Care Admissions, Donna Rugh

West Chester University Doctoral Projects

Patients appropriate for Home-Based Palliative Care services are fragile with increased risk for mortality and hospital readmissions. Utilization of Home-Based Palliative Care skilled nursing services have been proven to decrease these risks and improve quality of life. Information deficits negatively impact nurse clinical decision making during the admission process, potentially misguiding the nurse resulting in a non-admission to service. This project focused on the impact of both nurse education and clinical information sharing at admission. Pre and post data was compared to examine the impact of these interventions on non-admissions rates for the reasons of “no skilled need” or “not …

Enhancing Commercial Driver Safety Screening For Obstructive Sleep Apnea Through Educational Intervention, Wendy Mortimer

West Chester University Doctoral Projects

This quality improvement project aimed to identify if an educational intervention will increase obstructive sleep apnea (OSA) screening in commercial medical drivers over six weeks. Eight healthcare providers certified as commercial medical examiners from a national occupational company in central Pennsylvania engaged in an optional educational poster for two weeks. A pre-and post-educational retrospective chart review was performed on 80 charts, 40 from pre-educational and 40 from post-educational. Each chart was reviewed to determine if the commercial driver was at risk for OSA and, if so, if the commercial medical examiner performed an obstructive sleep apnea screening. The educational intervention …

Dying Is The Easiest Part: Implications Of Palliative Care In America, Sophia Jordan

Undergraduate Honors Theses

The purpose of this paper is to uncover why Americans fear death. What are the foundational principles that cause most individuals of the American society to prolong the dying process? The topics discussed will include physician bias, disease mongering by pharmaceutical companies, consequences of aggressive treatment, the barriers to palliative care and the specific effects of pediatric palliative care. There is a small amount of research on this specific topic, therefore, this paper also seeks to bring awareness to the benefits of palliative care. It is the overall aim of this paper for society to shift their beliefs towards the …

Effectiveness Of Harm Reduction And Narcan Education For Young Adults, Jason Bolfango

Nursing | Student Research Posters

Education on the Harm Reduction Model is an upstream preventative approach to addressing the opioid crisis and a strategic method to promote safety among young adults.

Increased Concern Of Suicide Behaviors In The Adolescent Population, Jaime Shareen-Porter Earle

Doctor of Nursing Practice Projects

This quality improvement project focused on addressing the concern for the increase of depression, anxiety, and self-harm behaviors among adolescents, which can lead to suicidal ideation and attempts. Suicide behaviors have increased among adolescents, and research revealed that suicide is the second leading cause of death in this population. An educational PowerPoint was presented to members of the community on suicide behaviors, how to identify the behaviors, and where to get support and resources in the community. Pre- and post-surveys were used to assess the participants' knowledge and confidence levels before and after project implementation. The surveys contained the same …

Essential Collaborations Among Case Managers And Providers Regarding Discharge Processes, Lashawnda Richardson

Doctor of Nursing Practice Projects

Communication is vital between case managers and providers when patients need care coordination post-discharge. This includes but is not limited to facilitating home health services, ordering durable medical equipment, sending referrals to rehabilitation facilities, and sponsorship for uninsured or underinsured patients. This gives case managers the opportunity to educate providers on the discharge needs they ordered for their patients. The collaboration between case managers and providers allows for timely discharge planning and providing patients and their families with accurate information regarding their discharge needs.

Cardiovascular Disease Improvement Project, Deglan K. Mccrystal

Doctor of Nursing Practice Projects

Health prevention promotes positive healthcare outcomes by identifying risk factors associated with a disease process in its early stages to halt or slow its progression. Preventions, like routine screenings, facilitate the identification of risk factors or the initiation of treatment of a disease. Identifying risk factors, which often go unrecognized, helps to manage conditions like cardiovascular disease before it progresses in severity. Early treatment options or identifying risk factors that lead to cardiac disease positively impact healthcare costs by reducing the number of hospital visits, emergency services, and the need for costly long-term care. Prevention increases the quality of disease …

Addressing Nursing School Retention: The Necessity Of Orientation In Nursing Education, Kerstin A. Queen

Doctor of Nursing Practice Projects

Nursing schools have been challenged to impact attrition and retention by creating an environment that increases student success. This DNP project was created to impact the current nursing shortage by increasing the number of nursing students who were retained after the first semester of nursing school. The DNP Project Leader designed a structured orientation program consisting of a 2-day in-person orientation and an online repository of resources. The DNP project sought to increase retention and provide pre-licensure students with gained skills to progress in the nursing program after the first semester in nursing school. The in-person orientation program provided participants …

Lived Experiences Of People With Substance Use Disorder As Healthcare Education To Develop Empathy For This Population, Whitney Bynum

Nursing | Senior Theses

The negative attitudes and feelings of healthcare workers towards patients with substance use disorder are well documented. These include, but are not limited to, believing a person with this disease is “drug seeking”, “violent”, and “unmotivated”. While this population has challenging issues to address, these beliefs can decrease the quality of care provided and results in less people seeking out needed treatment. Reducing stigmas through alternative education methods, like learning the life story of a patient, can help health care workers develop feelings of empathy and compassion. Subsequently, this education can result in better care and outcomes for these patients. …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Exploring The Impact Of Swimming On Asthma Management In Asian Americans, Trishtine Tran

Nursing | Senior Theses

Asthma is a respiratory disease that leads to narrowing of the airways in the lungs due to inflammation and mucus. Common symptoms include cough, wheezing, asthma attacks, excess mucus production, and decreased exercise tolerance. Pharmacological treatment methods for asthma include bronchodilators, corticosteroids, and allergy medications. Nonpharmaceutical treatments include monitoring of exposure to allergens and breathing exercises, however swimming is not as commonly suggested. The purpose of this study is to investigate whether implementation of a swimming education class will influence the effectiveness of swimming on asthma management in Asian Americans. This study aims to examine quality of life, changes in …

Empowering Caregivers In The Prevention Of Clinical Delirium For At Risk Older Adults Boarding In The Emergency Department Setting, Danielle Brewer

DNP Projects

Background: Emergency Department (ED) overcrowding is a global healthcare crisis documented in the literature for more than a decade, impacting patient outcomes and resource availability. While awaiting delayed transfer to an inpatient room, older adults in the ED remain vulnerable to developing acute delirium. Boarding potentiates the risk for worsening health outcomes, which are further compounded by delirium. Scarcity of resources and time constraints delay delirium detection and increase risk for down-stream hospital-acquired complications, higher cost, and prolonged length of stay. Current ED models do not prioritize caregiver partnership or involvement in delirium-conscious care, which is a holistic approach to …

Increasing Awareness Of Implicit Bias And Systemic Racism Among Clinical Staff Caring For Non-Hispanic Black Maternal Patients, Melissa Courtney

DNP Projects

Background: Kentucky is ranked 17^th in the nation for the highest maternal mortality rate in the U.S. with a rate of 22.9 per 100,000, and 78 percent of those maternal deaths were considered preventable. The Non-Hispanic Black maternal death rate in the U.S. and Kentucky is 2.9 times higher than that of the Non-Hispanic White maternal counterparts (Kentucky Department of Public Health Division of Maternal and Child Health (KDPHDMCH), 2022). The fundamental cause of maternal health inequities is structural racism, which leads to poor treatment and experiences in the healthcare system (Chinn et al., 2020). Structural racism and implicit …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

Increasing Annual Depression Screening For Adults In A Primary Care Setting, Sandy Zachery, Sheryl Winn, Flor Culpa-Bondal

Graduate Research Showcase

Increasing Annual Depression Screening for Adults in a Primary Care Setting

Background:

Depression is a mental illness that's common worldwide, which can cause an individual to function poorly in society and can progress to suicide. Because of several barriers, patients in a primary care environment are not being seen or treated for depression. Even though the U.S. Preventive Services Task Force (USPSTF) recommends that all adults in primary care receive annual depression screening that delivers effective treatment with the correct diagnosis and accurate follow-up, patients are still not being screened for depression.

Purpose:.

This project aims to improve …

Developing And Implementing A Sexually Transmitted Disease Screening Program To Decrease Chlamydia Cases On A College Campus, Amanda C. Harris

All Capstone Projects

Introduction: Sexually active college students were experiencing a high incidence, spread, and reinfection of the sexually transmitted Disease (STD) chlamydia on a university campus.
Purpose: To determine if implementing of a quality improvement program on campus utilizing a holistic approach would help decrease chlamydia cases. This program focused on fast-track STD screening, increasing knowledge about STDs, and addressing mental health issues.
Methods & Study Design: This was a descriptive/quasi-experimental design. Participants utilized the fast-track STD screening and completed surveys. Descriptive statistics and frequency tables were used to summarize survey responses for 1) the pre-and post-sexually transmitted disease (STD) education survey, …

Student Academic Success System, Brandi Castle

Doctor of Nursing Practice Projects

This project aimed to enhance academic success and retention rates in a practical nursing program through the implementation of a Student Academic Success System (SASS), utilizing evidence-based teaching strategies. A quality improvement design using both the Iowa Model of Evidence-Based Practice and the Plan, Do, Study, Act (PDSA) framework was guided by Kolb’s Model. Nurse faculty saw a need for increased student retention among practical nursing students; the student then proposed a plan, translated evidence, created a pre- and post-survey, and carried out SASS with the use of trained nurse faculty coaches. The goal of the project was to reduce …

Environmental Sustainability, Healthcare Workers And Healthcare Students: A Literature Review Of Attitudes And Learning Approaches, Pamela R. Mccauley, Kavita Mathur, Reza Kamali Miab, Nina Cohen, Kedena Henriques-Thompson, Jyo Gopinath

Health Professions Education

Purpose: Today, increased attention has been placed on the healthcare industry and its workers in the wake of the global COVID-19 pandemic. Increases in facemask production, personal protective equipment, and the number of patients admitted into hospitals have resulted in a sharp rise in medical waste and environmental concerns. This has led to a greater interest by the research community to study the type of training and education that healthcare workers and students receive which could facilitate the implementation of sustainability activities during their work.

Design/Methodology: We have conducted a literature review (2010 to 2024) on healthcare worker …

Impact Of An End-Of-Life Simulation On Nurses’ Attitudes, Self-Confidence, And Communication Skills, Amanda Scofield

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: New graduate nurses (NGNs) often lack exposure to end-of-life (EOL) care. Simulation experiences offer a safe place for learning and reflection. Implementation of an EOL simulation has the potential to increase NGNs attitudes, selfconfidence, and communication skills.
Methods: Forty-one NGNs in a nurse residency program participated in an EOL simulation. Attitudes toward EOL, self-confidence regarding EOL care, and EOL communication were evaluated using a pretest posttest format.
Results: Following the simulation, mean self-confidence scores increased, however the increase was not statistically significant (p = 0.53). Mean scores increased for 1 of 2 categories related to attitude toward EOL, however …

Implementation Of A Non-Pharmacological Cognitive Stimulation Therapeutic Activities Protocol As A Delirium Prevention Method For Adults, Jada Hieb

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Delirium is a complex clinical syndrome comprising a constellation of symptoms, including acute onset, inattention, altered level of consciousness, and disorganized thinking or cognitive dysfunction. Delirium is a common complication often unrecognized, expensive, and preventable. This project's focus was further exploring non-pharmacological delirium prevention strategies (NDPS).
Methods: A NDPS program using a therapeutic activity book (TAB) was implemented in a Midwestern acute care hospital measuring the impact on the number of positive delirium screens, the number of delirium diagnoses, and hospital length of stay (LOS).
Results: A causative relationship or association between the TAB and outcomes could not be …

Improving Preventive Care Tasks In Adults Aged 50 And Older With Pre- Visit Planning In Primary Care: Review Of Literature, Destinee Rice

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: Primary care providers are seeing an increased number of elderly patients with several chronic health issues. The time required to address multiple chronic health issues during an appointment impedes timely completion of preventive care tasks. Previsit planning can aid in closing this gap in preventative care by having all necessary information prepared before a patient’s visit.
Evidence Summary: A literature search was conducted in Cumulative Index to Nursing and Allied Health Literature and PubMed using subject headings and MeSH terms. The search was refined to include articles within the last 10 years. Articles were further narrowed down by their …

Implementing The Teach-Back Method On Pessary Utilization In A Urogynecology Clinic, Marissa Eich

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The effectiveness of pessary patient education using the teach-back method and improving nurse confidence and conviction related to pessary use are essential in improving patient outcomes.
/="/">Local Problem: The current limitations in pessary education stem from constraints in nurse availability and workload distribution.
/="/">Methods: The quality improvement initiative involved conducting surveys to evaluate nurse confidence using surveys adapted from the Agency for Healthcare Research and Quality toolkit before the nurse education session, 1 month into the intervention, and at 3 months, when the implementation period ended. These surveys assessed the effectiveness of the teach-back method.
/="/">Intervention: …

Reduction Of Pressure Injury Development In Long-Term Care Residents Using A Pressure Injury Prevention Plan And Communication Alerts, Joseph Osazee

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Accurate communication of changes in residents' skin condition and the provision of appropriate intervention in long-term care is key to ensuring patient safety and well-being through the prevention of pressure injury (PI) development. Effective use of a PI prevention plan and communication tools by certified nursing assistants (CNAs) and nurses can help in this regard.
/="/">Methodology: Thirty-three nursing staff attended an initial I -hour education session on how to identify changes in skin conditions and report them using the as needed (PRN) skin check tool or custom alert tool and implement interventions to prevent PI progression. The Pieper-Zulkowski …

Impact Of Evidence-Based Interventions On Nurse Burnout Among Ambulatory Care Nurses, Haley M. Lupher

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The physical and emotional demands of the nursing profession often cause increased stress and burnout in nurses. If burnout is not addressed, the negative consequences of burnout are perpetuated by one another. Evidence-based interventions, such as meditation, yoga, and physical activity can help reduce nurse burnout.
Local Problem: This project was completed at an ambulatory dermatology clinic that sees approximately 300 patients a day. In recent years, this department has noticed increased nurse turnover and low nurse morale.
Methods: A convenience sample from approximately 30 nurses was utilized. Burnout was measured using the Maslach Burnout Inventory for Medical Personnel …

Nurses' Knowledge, Confidence, And Compliance With An Ambulatory Surgery Discharge Checklist, Heather Van Marion

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Preventable errors in healthcare are fueling the growth of patient safety cultures. Checklists have been found to increase discharge accuracy and efficiency and detection of patient safety concerns before discharge.
Local Problem: Oversight errors can be traced back to poor communication or outdated workflows. Ad hoc communication and knowledge of physician preferences are no longer sufficient for ensuring complete discharge instructions. Methods & Interventions: A discharge checklist was developed and implemented in an ambulatory surgery department to ensure discharge instructions were complete and accurate. Nurses completed a pre and 3-month post-checklist questionnaire assessing their knowledge and confidence in the …

Implementation Of An Induction Of Labor Protocol, Rebecca A. Erickson

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Nationwide focus has been placed on the reduction of incidence of adverse maternal and neonatal outcomes in nulliparous, term, singleton, vertex (NTSV) patients.
Local Problem: Nursing leaders of a maternal child health unit in the upper Midwest recognized a need to reduce the rate of adverse maternal outcomes with evidence-based practice. The facility does not currently have an induction of labor (IOL) protocol.
Methods: The California Maternal Quality Care Collaboration Toolkit to Support Vaginal Birth and Reduce Primary Cesarean Sections was used to create an IOL protocol to prevent adverse maternal outcomes. Categorical outcome data was compared for 6 …

Implementation Of An Oral Sucrose Protocol For Advanced Practice Providers, Cori Shatto

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Pain in infancy due to immunization administration often goes untreated. The pain infants experience leads to negative effects on neurodevelopment and pain response. Needle fear develops in infancy and can extend into adulthood, leading to vaccine avoidance and endemic outbreaks. Methods: In a family practice clinic in an upper Midwest state, an oral sucrose protocol was implemented for use by advanced practice providers (APPs). Prior to education on the protocol, a survey was administered to assess the providers’ knowledge, attitudes, and practice (KAP) in relation to oral sucrose. The providers were educated on the benefits and intended use of …

Implementation Of A Daily Protocol To Reduce Central Line Days On A Medical-Surgical Unit, Katherine Wickstrom

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Central line associated bloodstream infections (CLABSIs) are preventable healthcare associated infections (HAI) in the United States. CLABSIs are associated with increased length of hospital stays, mortality, and financial implications for both patients and hospital systems. Extensive research has shown implementing CLABSI prevention bundles can reduce infections and costs. These bundles are often misused, highlighting the importance of bundle compliance and education.
Local Problem: A medical surgical unit in the upper Midwest continues to have delayed central line removal despite a CLABSI prevention bundle. Efforts to decrease central line days were identified as a priority.
Methods: Staff completed education on …

Implementation Of A Prediabetes Risk Assessment And Motivational Interviewing In Adults Ages 35 And Older, Emma Lilleberg

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The American Diabetes Association (ADA) recommends screening for prediabetes using a validated assessment tool in asymptomatic adults starting at age 35. An effective process to raise screening numbers to identify those at risk of prediabetes and diabetes is needed to provide quality care.
Methods: Nursing staff were educated on use of the risk assessment tool and principles of motivational interviewing (MI). Utilizing the ADA risk assessment tool identified those at risk. Nursing staff completed MI with individuals who scored 5 or higher. A readiness for change survey was completed by patients after receiving MI. Additionally, individuals received education on …