Nursing Commons^™

Evaluation Of A Substance Abuse Screening Tool In The Pediatric Emergency Room, Jody Sims

Dissertations

Abstract

Background: Substance abuse among adolescents is one of the most serious social health problems in the United States. The prevalence of alcohol use in adolescents is as high as 80%, while opioid overdose deaths among adolescents have risen by greater than 50% in the last 10 years. Alcohol, tobacco, and other substance use has also increased among youth and is not being properly evaluated in the pediatric hospital setting. The purpose of this project was to evaluate the use of a substance abuse screening tool with SBIRT trained staff in the pediatric emergency room setting.

Methods: The CRAFFT substance …

Improving Pediatric Asthma Outcomes Through Pictorial Asthma Action Plans, Julia Donovan

Dissertations

Problem: Asthma is the leading chronic disease of children and the leading cause of childhood emergency department (ED) visits, hospitalizations, and missed school days. Asthma action plans (AAPs), including photographs or pictures of asthma medications, symptoms, triggers, and devices, have improved parents’ understanding of their child’s asthma and have increased their comfort level in caring for their child.

Methods: An interventional pre-post study with a mixed-method research design, at a large, urban, primary care pediatric clinic with two locations, evaluated the effectiveness of a pictorial AAP on a child’s asthma control. A pictorial AAP was provided, and a childhood asthma …

Extubation Readiness Test In A Pediatric Cardiac Intensive Care Unit, Mary K. Holyoke

Dissertations

Extubation Readiness Test in a Pediatric Cardiac Intensive Care Unit

Abstract

Problem: The lack of standard extubation readiness tests (ERTs), that are practiced in pediatric ICUs to monitor extubation readiness, clinicians have the difficult task of weighing the risk versus benefit of extubation. ERTs can aid clinicians in deciphering patients ready to be successfully extubated and have shown to decrease length of mechanical ventilation and decrease extubation failures.

Methods: The quality improvement (QI) project utilized a descriptive observational design to assess the effects of the implementation of an ERT in a pediatric cardiac ICU. This project used a convenience sample …

Self-Care, Resilience, Self-Compassion, And Burnout In Doctoral Nursing Students: An Exploratory Needs Assessment, Logan Justice

Dissertations

Abstract

Problem: In the United States, one in three nurses experience symptoms of burnout, and doctoral nursing students are additionally challenged to juggle multiple school, work, and life demands (Reith, 2018; Woo et al., 2020). The purpose of this project was to explore the current self-care practices of doctoral nursing students to understand how self-care relates to resilience and burnout.

Methods: This exploratory needs assessment utilized a convenience sample of Doctor of Nursing practice (DNP) and Doctor of Philosophy (PhD) nursing students at a medium sized midwestern university. An electronic data collection survey was constructed to assess student self-care practices, …

Effect Of Confusion Assessment Scores On Identifying Delirium In Intensive Care Patients, Kayla Jacobs

Dissertations

Delirium in intensive care unit (ICU) patients can lead to increased length of stay in the hospital, increased risk of complications, increased polypharmacy, family distress and increased rate of mortality (Vasilevskis et al., 2018). Research has shown that addressing modifiable risk factors can improve survival rate by up to 15%, and routine screening for delirium in ICU patients leads to decreased patient anxiety, reduced in-hospital mortality, early recognition, and treatment of delirium (Krewulak et al., 2021 ; Vasilevskis et al., 2018). This quality improvement project used evidence-based intervention to increase accurate documentation of the confusion assessment method in the ICU …

Is Heart Health As Simple As Gut Microbiota?, Elizabeth A. Moxley

Faculty Articles, Papers, and Other Scholarship

The current mortality statistics for cardiovascular disease (CVD) in the United States (US) and on a global scale are staggering. CVD is responsible for approximately 31% of global deaths,¹ and approximately 25% of adults in the United States (US) have CVD.² The American Heart Association has identified eight primary measures for improving and maintaining cardiovascular health: Life’s Essential 8.³ However, a lesser recognized measure that has a profound effect on cardiovascular health has recently emerged,^4-5 that of the gut microbiome. The link between cardiovascular health and diet is not merely due to essential nutrients found in …

Rn To Bsn End-Of-Program Evaluation Revision, Nichol Tate

Doctor of Nursing Practice Projects

The data in an end-of-a-program student survey are crucial for maintaining a high-quality program and meeting accreditation standards. This quality improvement project aims to formulate a revised end-of-program evaluation survey for graduates to use to provide feedback to make necessary improvements to the program and employ better communication and access to educators for students to feel connected and important. After the item analysis method was used to review the questions and revise the survey, the revision of the survey was sent to the current summer RN to BSN students to complete and provide data about the overall program. Another method …

Improving Nurses Wound Care Knowledge Utilizing An App, Monica Amador

Student Scholarly Projects

Practice Problem: Nurses needed additional wound care support, but formal training was not in the budget at this time. Nurses needed a quick reference guide to help them assess, document, and treat wounds correctly until the hospital could provide adequate training.

PICOT: The PICOT question that guided this project is; “When treating wound care patients within a hospital setting (P), how does the implementation of a wound software app. (I) as compared to pre-existing nursing knowledge (C) increase a nurse’s self-reported ability to accurately assess and treat wounds (O) during a 10-week period? (T)”

Evidence: Based on a thorough and …

Clients In Uganda Accessing Preferred Differentiated Antiretroviral Therapy Models Achieve Higher Viral Suppression And Are Less Likely To Miss Appointments: A Cross-Sectional Analysis, Esther K. Nkolo, Jessica Clinkscales Ejike, Simon Sensalire, Juliana Nabwire Ssali, Immaculate Ddumba, Jacqueline Calnan, Carolina Gonzalez, Nelly Maina, Melaku Dessie, Lauren Bailey, Ugochukwu Amanyeiwe, Thomas Minior, Karishma Srikanth, Herbert Kadama, Khushi Patel, Dina Patel

Publications

INTRODUCTION: The Uganda Ministry of Health recommends facility- and community-based differentiated antiretroviral therapy (DART) models to support person-centred care for eligible clients receiving antiretroviral therapy (ART). Healthcare workers assess client eligibility for one of six DART models upon initial enrolment; however, client circumstances evolve, and their preferences are not routinely adjusted. We developed a tool to understand the proportion of clients accessing preferred DART models and compared the outcomes of clients accessing preferred DART models to the outcomes of clients not receiving preferred DART models. METHODS: We conducted a cross-sectional study. A sample of 6376 clients was selected from 113 …

Pcos Health-Related Quality-Of-Life And Depressive Symptoms Across The Lifespan: Comparative Study, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Abbas S. Tavakoli, Cynthia F. Corbett Phd, Rn, Faan

Publications

The purpose of this cross-sectional study was to compare health-related quality of life (HRQoL) and depressive symptoms among peri-postmenopausal women with polycystic ovary syndrome (PCOS) aged ≥43 years relative to premenopausal women with PCOS aged 18-42 years. An online survey link comprising questionnaires about demographics, HRQoL, and depressive symptoms was posted onto two PCOS-specific Facebook groups. Respondents (n = 1,042) were separated into two age cohorts: women with PCOS aged 18-42 years (n = 935) and women with PCOS aged ≥43 years (n = 107). Data from the online survey were analyzed using descriptive statistics, Pearson correlations, and multiple regression …

A Clinical Nurse Leader Nurse Navigator Program For Heart Failure Patients, Shanna Lantel Negron

Doctoral Dissertations and Projects

The purpose of this integrative review is to examine the literature regarding nurse-led educational interventions, transitional care (TC) strategies for heart failure (HF) patients, nurse navigation, HF self-care, and the clinical nurse leader (CNL) role to support integrating a CNL into the care delivery model serving as a nurse navigator (NN) for adult HF patients being discharged home from the hospital. The basis for this review is to identify an innovative way to improve patient reported and clinical outcomes for the HF population which increases each year. The economic and symptom burden associated with this disease is high further enhanced …

Stroke Symptom Identification Tool For Hospitalized Patients In A Rural Setting, Cheryl Ann Henderson

Doctoral Dissertations and Projects

Thousands of persons in the United States yearly suffer acute large vessel occlusion stroke (LVO). Caring for these individuals with strokes and the ensuing issues increases healthcare dollars. In underserved, rural communities, there is a dire need for improved methods to access care for these individuals. A 3-month evidence-based practice (EBP) project was conducted in a small rural town in Virginia with one of the state’s highest rates of acute stroke. Nurses in the rural hospital voluntarily participated in an educational program on recognizing acute stroke and utilizing the Vision, Aphasia, Neglect (VAN) assessment tool. The participants (N-15) were asked …

Nonpharmacologic Measures To Maintain Or Increase Bone Density In Patients At Risk For Osteoporosis: An Integrative Review, Katie Saporsky

Doctoral Dissertations and Projects

Osteoporosis is a major phenomenon, impacting a large proportion of the population of the United States. Effective prevention and mitigation strategies for this condition and its related complications are necessary to promote health and well-being for the aging population. Current pharmacologic agents used to combat osteoporosis bring the risk of adverse effects, resulting in poor patient adherence. Nonpharmacologic methodologies, specifically weight-bearing exercise, targeted nutrition, and whole-body vibration, have proven to be successful in increasing bone mineral density and mitigating the risk of osteoporosis and its related complications. Implementing these methodologies results in increasing bone mineral density, strength, and well-being.

Nursing Faculty Experiences Of An Academic Merger: A Transcendental Phenomenological Study, Sherry Michelle Boone

Doctoral Dissertations and Projects

The purpose of this transcendental phenomenological study was to describe the experience of undergoing a merger of two or more academic institutions within the United States for nursing faculty who chose to voluntarily depart the organization following the merger. The theoretical framework guiding this study was social capital theory as it discusses the importance of relationships and the resources those relationships provide. While assets may be acquired during a merger, social capital must be developed over time and is important for building a new combined healthy organizational culture. The study included nine participants who departed the institution in the timeframe …

Assessing And Strengthening New Provider Education Related To Extrapyramidal Symptoms And Antipsychotic Medication Usage, Mesiah O'Mar Porter Jr.

Doctoral Dissertations and Projects

Inadequate recognition and treatment of extrapyramidal symptoms (EPS) pose as a major liability to providers, as EPS can be life-threatening to patients, as they develop into metabolic syndrome, tardive dyskinesia (TD), or even death. Thus, insufficient usage of AIMS testing can negatively impact providers’ ability to meet associated care practice standards, when treating psychotic patients with antipsychotic medications. As a result, an evidence-based practice, quasiexperimental project was completed, utilizing the Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Healthcare. In alignment with this version of the revised Iowa Model, a pilot study was initiated to progress toward a formal …

Lung Cancer Screening Implementation, Jessica Lee Digiorgio

Doctoral Dissertations and Projects

The Lung Cancer Research Foundation has stated that lung cancer is one of the leading causes of death worldwide. In 2022, 236,740 individuals were diagnosed with lung cancer, and 130,190 American lives are lost annually from lung cancer. Smoking is the number one risk factor for lung cancer and is responsible for approximately 80% of deaths related to lung cancer. Because of the high mortality rates from lung cancer, the American Cancer Society recommends the use of the U.S. Preventive Services Task Force (USPSTF) screening tool. Individuals who meet the criteria defined by the USPSTF qualify for yearly low-dose computed …

Managing Burnout In Nursing, Karen Starnes Bell

Doctoral Dissertations and Projects

Burnout is a widespread phenomenon characterized by a reduction in energy that manifests in exhaustion, lack of inspiration, and feelings of frustration which may lead to reduced work efficacy and multiple absences. In the nursing profession, long hours, the pressure of quick decision-making, and the stress of caring for patients who may have poor outcomes may contribute to burnout. This integrative review was conducted to identify variables that contribute to nurse burnout and discover strategies organizations can implement to reduce or prevent nurse burnout.

Does A Telehealth Education Program Improve Lifestyle Behaviors Of Individuals With Prediabetes?, Loretta A. Richardson

Doctoral Dissertations and Projects

Chronic conditions are a considerable burden on the healthcare system, and one that is becoming increasingly prevalent is diabetes. Prediabetes is a condition that has become more common and diagnosed in many patients before an actual diagnosis of diabetes. Healthcare professionals strive to empower individuals to make lifestyle changes to prevent diabetes from occurring by informing individuals on how to manage prediabetes. For individuals that do not make the necessary changes to lower their hemoglobin A1c to below the standards of less than 5.6%, a diagnosis of diabetes occurs. It is estimated that five per 1000 individuals are diagnosed with …

Kangaroo Care Impact On Maternal Health: An Integrative Review, Alexis Ann Lawson

Doctoral Dissertations and Projects

Health care should progress and change as the needs of the population change. As light is shed on the mothers’ experiences during the postpartum period, there is an increasing need to find and implement evidence-based interventions to promote their health and wellness. As a vulnerable population, postpartum women require appropriate treatments and interventions to avoid postpartum complications. Three key themes of postpartum health and well-being that directly and significantly impact mothers are postpartum depression, maternal and infant attachment, and exclusive breastfeeding. This integrative review addressed the correlation between each of these themes and how kangaroo care, upright skin-to-skin contact, impacts …

Prenatal Educational Strategies To Increase The Duration Of Breastfeeding: An Integrative Review, Kayla Caryl Carter

Doctoral Dissertations and Projects

Although breastfeeding is the best source of nutrition for infants, many women in the United States of America do not breastfeed their infants. Infants should be breastfed for the first 6 months of life. Not only does this benefit the baby, but the mother as well. While prenatal education has been linked with improvements in breastfeeding rates, little research has been completed on which educational strategies are most effective. The purpose of this integrative review is to determine effective prenatal educational strategies for increasing the duration of breastfeeding. The strategies reviewed were single methods, multiple methods, and education with continued …

Strategies To Prevent And Manage Peri Wound Skin Complications Associated With Compression Bandages Application In Patients With Venous Leg Ulcers: An Integrative Literature Review, Judith D. Plummer- Morgan

Doctoral Dissertations and Projects

Skin maceration, pressure injury, skin-stripping, as well as less common dermatological problems, are frequently noted in patients treated for venous ulcers with compression bandages. Ongoing issues with infection can lead to unwanted effects, including hospitalization and unexpected expenses. This integrative review was synthesized using Whittemore and Knafl’s five-stage methodological framework. A systematic search was conducted through the following online databases: CINAHL, MEDLINE, PubMed, and ScienceDirect for articles available in English and available in full text. This integrative review aims to review, synthesize, and critique the current literature to determine what strategies have been implemented to prevent or manage dermatological problems …

Assessment And Documentation Of Social Determinants Of Health Among Health Care Providers: Qualitative Study, Brooks Yelton Ma, Lmsw, Jancham Rachel Rumthao, Mayank Sakhuja, Mark M. Macauda, Lorie Donelle Phd, Rn, Fcan, Michelle Angelique Arent, Xueying Yang, Xiaoming Li, Samuel Noblet, Daniela B. Friedman

Publications

BACKGROUND: Research clearly demonstrates social determinants of health (SDOH) impact health outcomes. Provider consideration of patient SDOH in prevention and treatment planning is critical for improved health care quality and health equity. Despite awareness of the connections between SDOH and improved population health, research demonstrates few providers document patient SDOH. OBJECTIVE: This qualitative study aimed to better understand the barriers and facilitators of SDOH assessment, documentation, and referral in different health care settings and roles. METHODS: Individual semistructured interviews were conducted with practicing health care providers in South Carolina between August 25, 2022, and September 2, 2022. Participants were recruited …

Improving Interprofessional Value-Based Care For Residents In Skilled Nursing Facilities., Alisha Mitchell

Doctor of Nursing Practice Papers

Background/Significance: Providers may unknowingly impede residents’ equitable treatment without understanding ethnocultural diversity and values, thus preventing residents and their families from receiving care consistent with residents’ values and beliefs.

Purpose: This project aimed to improve equitable healthcare with spiritual and ethnocultural congruence integrated into care processes and workflow in a skilled nursing facility.

Methods: The Institute of Healthcare Improvement model for improvement (MFI) and an adapted evidence-based practice guideline guided the quality improvement project, implemented in one section of a 60-bed long-term care unit at a skilled nursing facility.

Practice Change: Process and care delivery workflow …

Proactive Toileting: Strengthening Purposeful Hourly Rounding's Influence On Patient Falls., Brittany Pollock

Doctor of Nursing Practice Papers

The purpose of this DNP quality improvement project was to decrease patient falls on a 21-bed step-down telemetry unit in a Kentucky metropolitan hospital. This project implemented proactive toileting in conjunction with purposeful hourly nursing rounds. A pre-education survey was given one week before the education module, and a post-education survey was provided six weeks after the education module was opened. Pre- and post-survey scores were compared to assess any changes in staff’s understanding of proactive toileting and project goals. Falls were measured, and compliance with proactive toileting was monitored in the electronic health record over an 8-week course. Compared …

Decreasing Restraint Times On An Inpatient Psychiatric Unit., Maria Siegel

Doctor of Nursing Practice Papers

Restraints are widely used on inpatient psychiatric units when psychiatric patients exhibit escalating behaviors. Physical restraints, including seclusion, increase patients’ risk for injury and psychological trauma. Acute inpatient psychiatric units should aim to use restraints only as a last resort and for as little time as possible to keep the patient and others safe. The literature suggests that ways to decrease restraint rates on inpatient psychiatric units include risk assessment for early identification and proper use of alternative measures. Nursing staff education has been proven to play an important role in decreasing overall restraint times on inpatient psychiatric units. The …

Implementation Of A Progressive Muscle Relaxation Intervention To Decrease Cancer Patients' Distress: A Quality Improvement Project., Theresa Thomas

Doctor of Nursing Practice Papers

Background: People affected by cancer often experience psychological distress that ultimately decreases their health, adherence to treatment, overall well-being, and quality of life. Research has shown that MBIs can reduce psychological distress, depression, and anxiety and increase quality of life. A needs assessment conducted within a local cancer support organization, Gilda’s Club Kentuckiana, has expressed the need for providing a more comprehensive range of accessible MBIs in their programming to meet their psychosocial goals by reducing psychological distress in their members. PMR is an MBI not currently used by GCK that has been proven effective at reducing anxiety, depression, and …

Evaluating The Effectiveness Of A Standardized Mobile Vaccination Clinic Training Program For Team Leaders In Reducing Vaccination Administration Errors., Valenchia Brown

Doctor of Nursing Practice Papers

In response to the urgent need for mobile COVID-19 vaccination clinics, the Kentucky Nurses Association (KNA) developed a standardized training program aimed at equipping nurse leaders with the necessary tools and resources for safe and efficient vaccine administration, free of vaccination errors, during mobile vaccination clinics. The purpose of this study was to assess the process effectiveness of the training program as perceived by team leaders and evaluate the number and types of vaccination errors during these clinics. The CDC’s Logic Model served as the framework for this project. The interventions included team leaders undergoing standardized training outlined in the …

Increasing Music Therapy Referrals In A Surgical Intensive Care Unit., Brandi Cecil

Doctor of Nursing Practice Papers

Medications have been the primary intervention in intensive care unit patients due to the fact that the patients are often unconscious, critically medically ill, or unable to actively participate in nonpharmacological treatment. Researchers have found the integration of music therapy in patient care has helped ease pain, anxiety, and stress, and has been useful in vital control, such as decreasing heart rate and respiration count. A study was conducted in a surgical intensive care unit (SICU) to examine the benefits of increasing music therapy consults. Critical care nurses were educated on the advantages of utilizing interdisciplinary care by consulting music …

Intention To Change Lifestyle Behaviors In 10- To 14-Year-Old Children With Obesity., Mallory Swanson

Doctor of Nursing Practice Papers

Background: Pediatric obesity is a multifaceted disease that affects 19.7% of children. Obesity increases the risk of long-term health morbidity and costs billions of dollars annually for the United States healthcare system.

Purpose: The objective of this quality improvement project was to utilize the 5210 Healthy Children Campaign to facilitate behavior change in obese children. Potential outcomes include fostering health promotion and disease prevention, improving patient outcomes, decreasing morbidity and mortality, and easing the healthcare burden.

Methods: Intervention took place at Growing Kids Pediatrics and was conducted through four educational sessions involving the obese child and at least one caregiver. …

Improving Catheter-Associated Urinary Tract Infections In The Intensive Care Unit: Implementation Of A Rounding Tool To Enhance Communication And Collaboration., Bethany Carol Risen

Doctor of Nursing Practice Papers

Background/Significance: Catheter-associated urinary tract infections (CAUTIs) are avoidable and costly healthcare-associated infections (HAIs) and are associated with high morbidity and mortality. A rise in CAUTIs at the project site, and the need for a standardized CAUTI prevention communication process, prompted this quality improvement project.

Purpose: The purpose of this quality improvement project was to decrease CAUTIs through improved communication and collaboration amongst the critical care team.

Methods: Twelve nurses completed the Collaboration and Satisfaction about Care Decisions (CSACD) questionnaire pre- and post- intervention which, evaluated communication and collaboration. Nurses also assessed IUC indication and removal during interdisciplinary rounds.

Intervention: This …