Nursing Commons^™

Engaging Nurses With In-Person Multidisciplinary Education, Caitlin Silva

Articles, Abstracts, and Reports

"Title: Engaging Nurses with In-Person Multidisciplinary Education

By Caitlin Silva MSN, RN, CCRN, SCRN

Purpose:

This project was to evaluate the impact of “Brain Day,” a targeted multidisciplinary continuing education (CE) class that utilized in-person teaching to promote engagement and satisfaction among nurses in a progressive care unit (PCU).

Relevance/Significance/Background:

Staffing shortages have reached critical levels and educators are tasked to find new ways to increase engagement and satisfaction. Perceived organizational support and workplace relationships have a significant impact on retention. Required contact hours can be used to address staff identified learning needs to keep CE relevant and promote satisfaction. …

Preliminary Efficacy, Feasibility And Safety Of Intra-Umbilical Oxytocin To Reduce The Time To Placental Delivery At Caesarean Section: An Exploratory Randomized Trial, Katrin Middleton, Fungai Mbengo, Thandisizwe R. Mavundla, George J. Hofmeyr

Research outputs 2022 to 2026

Background: Delayed placental separation either after vaginal birth or caesarean birth is an important cause of postpartum haemorrhage, among other causes such as uterine atony. Intra-umbilical oxytocin has been shown to reduce the time to placental delivery after vaginal birth. However, the efficacy of intra-umbilical oxytocin to reduce the time to placental delivery following caesarean section birth is not known. Objectives: To explore the preliminary efficacy, feasibility and safety of intra-umbilical oxytocin to reduce the time to placental delivery at caesarean section. Methods: A double-blind, placebo-controlled, exploratory randomized clinical trial was conducted at a tertiary hospital in the Eastern Cape …

Sex Differences In Cholesterol And Triglyceride Levels Among Hospitalized Adolescents And Young Adults With Eating Disorders, Jason M. Nagata, Anita V. Chaphekar, Ruben Vargas, Anthony Nguyen, Amanda E. Downey, Khushi P. Patel, Kyle T. Ganson, Elena Stuart, Siena Vendlinski, Sara M. Buckelew, Andrea K. Garber

Publications

OBJECTIVE: To determine sex differences in cholesterol and triglyceride levels among adolescents and young adults hospitalized for medical complications of eating disorders. METHODS: A retrospective electronic medical record review of patients aged 9-25 years admitted to the University of California, San Francisco Eating Disorders Program for medical stabilization, between 2012 and 2020, was conducted. Non-fasting total cholesterol and triglycerides were collected; however, LDL and HDL levels were not available. RESULTS: Among 83 males and 441 females, mean ± SD age was 15.5 ± 2.8 years, 64.1% had anorexia nervosa, and admission percent median body mass index was 87.3 ± 13.9. …

Impact Of Preparing Nursing Students To Deliver A Parent-Based Sexual Health Intervention On Attitudes And Intentions For Sexual Health Education And Parent Communication Counseling: A Mixed Methods Study, Deidra Carroll Coleman, Anitra Frederick, Stanley Cron, Christine Markham, Vincent Guilamo-Ramos, Diane Santa Maria

Faculty, Staff and Student Publications

BACKGROUND: Nurses are well positioned to promote sexual health but are not adequately prepared in their nursing programs to engage families on this topic and often lack the knowledge and confidence necessary to counsel families about sexual health communication. The purpose of this study was to determine how facilitating a parent-based sexual health intervention would impact nursing students' attitudes and intentions about sexual health education and parent communication counseling.

METHODS: Using an embedded mixed-methods design, which integrated a quasi-experimental framework, we examined the impact of participation in a parent-based sexual health intervention among 126 baccalaureate nursing students enrolled in a …

Sparx: Elucidate Single-Cell Spatial Heterogeneity Of Drug Responses For Personalized Treatment, Ziyang Tang, Xiang Liu, Zuotian Li, Tonglin Zhang, Baijian Yang, Jing Su, Qianqian Song

Publications

Spatial cellular authors heterogeneity contributes to differential drug responses in a tumor lesion and potential therapeutic resistance. Recent emerging spatial technologies such as CosMx, MERSCOPE and Xenium delineate the spatial gene expression patterns at the single cell resolution. This provides unprecedented opportunities to identify spatially localized cellular resistance and to optimize the treatment for individual patients. In this work, we present a graph-based domain adaptation model, SpaRx, to reveal the heterogeneity of spatial cellular response to drugs. SpaRx transfers the knowledge from pharmacogenomics profiles to single-cell spatial transcriptomics data, through hybrid learning with dynamic adversarial adaption. Comprehensive benchmarking demonstrates the …

Antimicrobial Resistance And Rational Prescription Practices: Knowledge, Perceptions And Confidence Of Health Profession Interns In Uganda, Shamim Nabidda, Rogers Ssennyonjo, Joseph Atwaru, Andrew Marvin Kanyike, Shiellah Baryayaka, Kennedy Pangholi, Jonans Tusiimire

School of Nursing & Midwifery, East Africa

Background

Antimicrobial resistance (AMR) is significantly driven by misuse and overuse of antibiotics. Graduate health profession interns often prescribe antimicrobials under minimum supervision.

Objectives

This study explored the knowledge, perceptions and confidence of health profession interns in Uganda regarding AMR and rational prescription practices.

Methods

This was a cross-sectional survey employing quantitative techniques carried out between October and November 2022 at six tertiary hospitals in Uganda. Health profession interns including doctors, nurses, midwives and pharmacists were recruited as study participants. Data were collected using online Kobo toolbox software. Data analysis was performed using STATA (StataCorp) version 16. Bivariate analysis and …

Mental Health Suicide In Alabama, Michael Schurdell

University Faculty and Staff Publications

Mental health and suicide are significant issues in Alabama, a state that ranks 46th out of the 50 states and Washington D.C. in access to mental health services. Alabama’s suicide rate is 59% higher than its homicide rate of 8.3%. This crisis is particularly acute among Caucasian males aged 45-54, who account for 71% of suicides; this demographic is four times more likely to commit suicide than females and three times more likely than African Americans. High suicide rates correlate to a lack of available resources across the state, especially in rural communities. The closure of mental health facilities has …

Unlocking Vr Magic: Duration Of Anxiety Relief For Pediatric Needle Procedures, Anna Angelica Mendoza

Nursing | Student Research Posters

No abstract provided.

How Important Are Regular Breaks For Bedside Nursing Staff?, Gabriel Wohl

Nurse Residency

Background: A career in nursing can be a challenging one and a rewarding one. Nurses work directly with patients in need, in a way that their efforts have an immediate and tangible impact. Due to the nature of the work itself, nursing is also a physically, mentally, and emotionally demanding career that often leads to exhaustion, burnout, and in many cases, a departure from the profession altogether. It is well known that nurses work long hours and often receive little to no breaks. Is this lack of proper breaks a chief accessory to the overall dissatisfaction and burnout that nurses …

Smoking Cessation Post-Discharge For Medical Surgical Patients, Jessica Francis, Julie Lavery

Nurse Residency

Introduction: Does the combination of behavioral counseling coupled with medication (vs medication alone) result in greater smoking cessation for our patients after discharge?

Implementation Of Frequent Skin Assessments, Tiffany Gagnon

Nurse Residency

Background:

The current skin assessment policy at the Behavioral Health Unit at Southern Maine Health Care requires more frequent skin checks for patients who are immobile in a mental health department.

The Agency for Healthcare Research and Quality (AHRQ) reports “hospital-acquired pressure injury rates continue to rise across the United States” (Pittman et al., 2022).

Uab Nursing - Fall 2023, University Of Alabama At Birmingham

UAB Nursing magazine

No abstract provided.

The Registered Nurse, Fall Prevention, And Mobilization Alarms, Anna Williams

Nurse Residency

Background:

Current Maine Health policy requires response to a mobilization alarm within 5 minutes by a RN, CNA or other clinician. Fall risk assessments are required upon arrival and admission, at the beginning of each shift, transfer between units, changes in patient condition and after a fall.

Current practice involves the TIPS tool.

Robotic Vs. Laparoscopic Bariatric Surgery, Chloe Aiken, Abigail Reera

Nurse Residency

Background: As OR nurses, we have seen an increase in the number of robot-assisted bariatric surgeries instead of being performed laparoscopically. In the United States, the first surgical robotic telepresence system became available in 1987. From there, IntuitiveSurgical, Inc. reworked that system to create numerous prototypes leading to the DaVinci series that we utilize at SMHC.

Initiating Chlorhexidine Wipes For Infection Prevention In The Icu, Samantha Carey

Nurse Residency

Background

• Central line-associated bloodstream infections (CLABSIs) result in approximately 28,000 deaths and approximately $2.3 billion in added costs to the U.S. healthcare system each year, and yet, many of these infections are preventable (Reynolds, 2021).

• Chlorhexidine gluconate (CHG) is an antiseptic that can be used for skin cleaning and has been shown to be effective against a wide range of organisms, including some antimicrobial-resistant organisms.

• The primary objective of this study was to assess the incidents of CLABSI’s when CHG wipes were implemented compared to traditional bathing soap and water for patients with a central line in …

Impact Of Discharge Teaching On 30-Day Readmission Rates In The Incarcerated Patient Population, Natasha P. Walker

Doctor of Nursing Practice Scholarly Projects

Problems Statement: Current incarcerated patient policy prohibits communicating discharge information to the patient on day of discharge to mitigate elopement risk. Purpose: The purpose of this DNP project is to improve hospital quality metric 30-day readmission rates in the incarcerated patient population by implementing a trial period of discharge teaching the day of discharge. Method: Implementation of discharge teaching utilizing the Krames patient education standardized discharge teaching tool integrated within the health system’s electronic health record. Analysis: The project’s initial plan to use the Pearson correlation coefficient to evaluate relationship between 30-day readmission rates and standardized discharge teaching on the …

Use Of A Palliative Care Trigger Tool In A Surgical-Trauma Intensive Care Unit, Courtney Thomas

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Patients are not habitually screened for palliative care consultations, and there is no protocol for initiating communication with palliative care. Not only is this a problem at the local and state level, but only about 5% of acute care patients nationally are estimated to utilize palliative care services. This delay in specialty care that palliative consultations could provide negatively impacts patients. Purpose: This evidence-based practice (EBP) project aimed to determine if a palliative care trigger tool in an intensive care unit (ICU) would increase the number of palliative care consultations. Methods: A pre-implementation survey was distributed to ICU …

Integration Of Problem-Solving Therapy To Address Mental Health Needs Of Family Medicine Patients, Robert M. Sutter

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Patients in Family Medicine at an academic medical center in the Southeast who show signs and symptoms of depression are being referred to behavioral health to manage their depression symptoms. Long waiting lists, which delay the patient’s time to see behavioral health and a lack of patient education about the need for mental health services led to delays in patient care and poor appointment adherence.

Purpose: The purpose of this project was to determine if providing Problem Solving Therapy (PST) in a one-time setting, after referral from the primary care provider (PCP), with psychoeducation, decreases depression scores for …

Implementation Of A Pcp Referral In Urgent Care For Patients With Hypertension, Teri Alesha Scott

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adult patients with uncontrolled hypertension at Saluda Pointe Urgent Care (SPUC) do not have an established primary care provider (PCP) for follow-up.

Purpose: To improve access to care by establishing patients with uncontrolled hypertension (>140/90) with a PCP.

Method: Implement a PCP referral at SPUC for patients with uncontrolled hypertension. The Primary Care Connection Center (PCCC) contacted the referred patients within 72 hours to schedule an appointment. An Organizational Change Management (OCM) Solutions survey measured provider attitude and readiness for change before and after implementation.

Inclusion Criteria: Adult patients 18 and older, without an …

A Response Team Approach To Reducing Restraint Use In The Emergency Department, Sarah Place

Doctor of Nursing Practice Scholarly Projects

Assaults on staff are doubling in the healthcare field, and due to the urgent need to secure the environment, the use of restrictive measures is at times, the safest choice. The following project examined the implementation of a Behavioral Emergency Response Team approach in an Emergency Department, and the effects it had, on reducing the use of violent restraints, assaults on staff, and increase confidence of staff in managing difficult situations. An anonymous survey was used to measure staff confidence while handling agitated patients, and an event report was used that identified if de-escalation techniques were employed to assist in …

Improving The Discharge Process In A Post-Acute Care, Skilled Nursing Facility To Decrease Hospital Readmissions, Shantoria W. Parker

Doctor of Nursing Practice Scholarly Projects

Problem: Older adults recently discharged from a skilled nursing facility (SNF) (often referred to as short-stay facilities) experience a period of vulnerability while transitioning back into the community, placing them at increased risk of adverse events, including hospital readmissions (Anderson et al., 2021). Completing a timely appointment (within 7 days) with primary care providers following discharge into the community reduces patients’ risk of preventable hospital readmissions (RHI, 2023) through interventions aimed at promoting coordinated care and safe transitions (Patel et al., 2019). However, more than 50% of readmitted patients failed to visit a primary care provider's (PCP) office between SNF …

Early Palliative Care Screening Among Solid Tumor Oncology Patients, Kaitlin Lothe

Doctor of Nursing Practice Scholarly Projects

While there are extensive benefits of integration of early palliative care, referral to this specialty tends to occur late in the disease course after some form of suffering has already occurred (Hausner et al., 2021). The purpose of this DNP student’s quality improvement project was to improve care coordination and increase rate of palliative care referrals of solid tumor oncology patients through implementation of an evidence-based trigger tool for palliative care screening. Participants were recruited from a 36-bed inpatient adult medical oncology unit where identified patients meeting criteria were included in the study. Data for this study included participant demographics, …

Implementation Of “The Pause” To Promote Clinician Wellness, Aishia Shonta Jennings

Doctor of Nursing Practice Scholarly Projects

Clinicians experience work-associated trauma after unsuccessful resuscitation efforts and may internalize the trauma unless it is addressed. The purpose of this DNP project was to conduct a pilot to determine whether “The Pause” is a practice that could be adopted throughout the organization to promote clinician well-being after patient resuscitation efforts, often called a “code blue” event. The model for this evidence-based practice change is the six-step Rosswurm and Larrabee (1999) model. Data analysis included six measures: the number of code blue events that occurred during the implementation period, the number of code blue events that were unsuccessful in patient …

Patient Outcomes Following The Implementation Of A Cardiogenic Shock Algorithm, Alana E. Hall

Doctor of Nursing Practice Scholarly Projects

Problem Statement: ST-elevated myocardial infarction (STEMI) is one of the leading causes of cardiogenic shock (CS) associated with increased in-hospital mortality. Despite multiple efforts to improve outcomes, mortality remains high.

Purpose: This quality improvement project aimed to analyze the impact of a cardiogenic shock algorithm on survival to discharge for STEMI patients.

Methods: A CS algorithm was implemented at a cardiac catheterization laboratory on October 3, 2022. Using the Plan-Do-Study-Act quality improvement framework, data was retrospectively collected on patients presenting with a STEMI who meet CS criteria to determine if there was improved survival to discharge after implementing …

Impact Of A Toolkit On Fall Prevention In An Acute Midsized Rehabilitation Facility In The Southeast, Shantai D. Allen

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Older people in hospitals may face a greater risk of falls due to the use of medication, lower body weakness, and some difficulty with balance and walking. Over the past five years, there has been a steady increase in the prevalence of falls with the targeted unit reporting over 5 falls per 1000 patient days, which is higher than the national average. Purpose: The purpose of this project was to decrease falls and decrease falls with injuries in this patient population. Methods: The project employed a pre-post intervention design that measured fall incidence in the targeted unit after …

Implementation Of A Nurse Driven Urinary Catheter Protocol: A Quality Improvement Project For Adult Patients, Jamie H. Dagenhart

Doctor of Nursing Practice Scholarly Projects

Introduction: Studies have shown a relationship between management and use of indwelling urinary catheters on catheter days and catheter-associated urinary tract infections (CAUTIs), in adult patients in intensive care units (ICUs). Globally, increases in catheter days and CAUTI rates have led to poor patient outcomes, increased lengths of hospital stay, and increased hospital costs. In efforts to inhibit these adverse effects, institutions have developed protocols specific to reducing CAUTIs in hospitalized patients. This paper argues that a multifaceted nurse driven indwelling urinary catheter protocol will positively influence number of catheter days and change in practice, in the proposed institutional settings. …

Assessing Organizational Readiness For Evidence-Based Practice (Ebp) Change For The Implementation Of A Postoperative Neuropathic Mastalgia (Pnm) Scale Among General Surgery Ambulatory Practices, Jessica Terry Gonzalez

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Assessing postoperative neuropathic mastalgia (PNM) among oncology breast surgical patients is not commonly performed using a surgery specific pain scale at large South Carolina healthcare organization and is historically misdiagnosed, mismanaged, despite representing a common and significant complication (Gong et al., 2020; Humble et al., 2015; Mejdahl et al., 2019). Studies show that early identification of patients with neuropathic-specific pain following breast cancer-related surgery facilitates better pain management and patient outcomes (Pereira et al., 2017; Sipilä et al., 2012). Assessing organizational readiness to adopt Evidence-Based Practice change is recommended to facilitate the identification of potential barriers to implementation …

Increasing Hpv Vaccination Uptake In Female College Students Aged 18-26, Gabrielle B. Scott

Doctor of Nursing Practice Scholarly Projects

Human papillomavirus (HPV) is the most common sexually transmitted infection in the world. Most people infected with HPV remain asymptomatic, but infections may result in several types of cancer. Three HPV vaccines are available with the recommended initiation of vaccination between 11–12 years, but the vaccine may be administered to females through 45 years old. Despite HPV vaccine efficacy, vaccination rates among college-age students remain low, particularly in certain geographical areas such as the Southeastern United States. This project aimed to increase HPV vaccination uptake among females between the ages of 18-26 in the Women’s Health Clinic through patient education …

Understanding The Gap Between Nursing Workforce In The United States And Population Needs-A Policy Brief, Mayar Al Mohajer

Faculty, Staff and Students Publications

Purpose  This report is intended to analyze the root causes for the current gap between the nursing workforce and population needs in the United States. It aims to consolidate what is known about these contributing reasons and provide evidence-based recommendations for action.

Methods  The report utilized the Sample, Phenomenon of Interest, Design, Evaluation, Research type framework to develop the research question and the 5 Whys methodology for the root cause analysis.

Results  This report highlighted six major causative problems, including workforce market mismatch, poor financing design, inadequate governance, flawed technologies, insufficient research, and suboptimal service delivery. A detailed evaluation of …

Evaluation Of A Revised Clinical Ladder Program In Addressing Clinical Competence And Performance, Accountability, Professional Growth, Rewards And Benefits, Job Satisfaction And Engagement, And Autonomy And Decision Making, Vaughn Hansen Msn, Rn, Ne-Bc

Doctor of Nursing Practice Projects

Background: The surge of nurses leaving the profession has increased in recent years raising concerns that unless systemwide changes are implemented this trend will increase exponentially for years to come. Healthcare organizations struggle to retain an experienced, competent nursing workforce and seek ways to keep them from leaving. A clinical ladder program is one potential method being implemented in which healthcare organizations mitigate the exodus of nurses and create a healthier work environment.

Objectives: This doctoral project aimed to measure the perceptions of how well a revised clinical ladder program influenced the nursing workforce satisfaction in the following areas: clinical …