Nursing Commons^™

Effectiveness Of An Electronic Health Record Embedded Evidence-Based Testing Algorithm For Clostridioides Difficile Infection., Sarah Marie Bishop

Doctor of Nursing Practice Papers

Background: Clostridioides difficile infection (CDI) commonly impacts hospitalized patients with almost half a million cases reported in the United States annually. C. difficile colonization is more common than infection. Identifying true infection versus colonization is critical to avoiding inappropriate treatment, unnecessary exposure to antibiotics, and increased cost of care. Implementation of evidenced-based CDI testing criteria can help reduce inappropriate CDI testing and avoid the misidentification of colonized patients as true CDI.

Purpose: The purpose of this project was to evaluate the effectiveness of an evidence-based electronic health record (EHR) integrated CDI testing algorithm in reducing inappropriate CDI testing among adult …

Improving Postoperative Breast Augmentation Patient Education Delivery., Madison Callery

Doctor of Nursing Practice Papers

Background: Effective patient education promotes successful postoperative outcomes. Nurses in an outpatient surgery center lacked consistent patient education practices and materials.

Purpose: The purpose of the project was to implement an evidence-based multimodal educational strategy for patients who undergo breast implant surgeries.

Methods: At an outpatient plastic surgery center, pre- and post-intervention phone calls were tracked; post-intervention education, documentation, and patient satisfaction data were recorded. Nurses were educated on the new materials, delivery procedures, and electronic health record (EHR) documentation. All patients undergoing breast implant surgery received multimodal education at each postoperative appointment. Outcomes included (1) the number of patient …

Recognizing And Reporting Of Child Maltreatment In A Pediatric Primary Care Setting., Jennifer L. Dumey

Doctor of Nursing Practice Papers

Child abuse and neglect, together known as child maltreatment, is a global problem with grim lifelong consequences (WHO, n.d.). Education and confidence in reporting child maltreatment are imperative for medical providers who are responsible for the evaluation of children during routine visits with pediatric providers. Research continues to link child maltreatment with adverse health outcomes that span throughout a person's lifetime. For this reason, medical providers must be provided with continued education on early recognition and reporting of concerns for child maltreatment.

The purpose of this project is to increase provider knowledge on the identification and reporting of child maltreatment. …

New Ways To Impact Primary Palliative Care Practices Using Online Continuing Education, Charlene Barke, Sarah Mollman, Amy Skoglund, Brandi Pravecek, Mari Perrenoud, Carol Stewart

College of Nursing Faculty Publications

Background: Healthcare professionals trained in palliative care (PC) improve satisfaction and decrease healthcare overutilization for patients with serious illness and their families. A continuing education (CE) series on primary PC aligned to the National Clinical Practice Guidelines for Quality PC was developed by local, interdisciplinary experts for a target audience of rural, primary care healthcare professionals. The modules were accessed on an online learning management system platform.
Objective: The study objectives were to assess differences in participants’ knowledge, competence, performance, and ability to improve patient care as well as commitment to change practice after taking each of the CE modules. …

Utilization Of Modified Early Warning Scores (Mews) To Decrease In-Hospital Cardiac Arrests (Ihca), Ashley Bryan

Doctor of Nursing Practice Projects

Background: Less than 25% of patients survive to discharge after an in-hospital cardiac arrest (IHCA). The American Heart Association (AHA) aimed to increase the survival to discharge after IHCA to 35%, according to the AHA Get with the Guidelines (GWTG). Pre-implementation of MEWS-based rapid response rounding the facility had a 24% survival to discharge rate after IHCA.

Purpose: The Doctor of Nursing Practice (DNP) project aimed to improve the survival to discharge percentage after IHCA by implementing MEWS-based rapid response rounding on all patients with a MEWS of four or greater.

Methods: The quality improvement project consisted of having rapid …

Utilizing Mhealth To Increase Follow-Up In Latinx Adults With Hyperlipidemia., Jessica Raymond Richards

Doctor of Nursing Practice Papers

Background: Management of hyperlipidemia (HLD) is crucial to the prevention and management of cardiovascular disease cardiovascular disease (CVD), a leading cause of death in the United States (US) and Latinx adults (Centers for Disease Control and Prevention (CDC), 2019). The main difficulty affecting monitoring of lipid levels in patients diagnosed with HLD is lack of adherence to follow-up appointments.

Purpose: The purpose of this Quality Improvement (QI) project is to evaluate the impact of culturally competent translated short message service (SMS) texts to increase adherence follow-up on a Latinx population served at the Kentucky Racing Services Health Center (KRSHC).

Intervention: …

Improving Post-Stroke Dysphagia Screening In The Intensive Care Unit., Chelsea Bills

Doctor of Nursing Practice Papers

Background: Dysphagia screening is a critical aspect in the care of patients experiencing acute stroke and dysphagia may often determine life or death following a stroke event. Inconsistent nurse dysphagia assessment and documentation were identified in the Medical/Surgical Intensive Care Unit project organization.

Purpose: The purpose of this project was to explore the impact of an educational program on stroke nurse dysphagia screening and nursing self-efficacy in the ICU.

Methods: Fifteen nurses completed a modified General Self-Efficacy Scale survey which measured nurse perceptions of change in their own self-efficacy to perform dysphagia screenings; dysphagia screening rates and rates of dysphagia …

The Use Of Two Nurses, Four Eyes On Skin Assessments To Reduce The Incidence Of Pressure Injuries In Medical-Surgical Patients, Tiffany Bass

Doctor of Nursing Practice Projects

Background: Hospital-acquired pressure injuries (HAPIs) adversely affect at-risk patient populations and hospital settings. HAPIs increase the risk of death in vulnerable patient populations (Wassel et al., 2020). In addition, HAPIs cost healthcare agencies $9 to $11 billion annually (Padula & Pronovost, 2018). Inconsistent completion and documentation of the patient’s skin assessments both upon admission and daily throughout their hospital stay are identified barriers to improving patient outcomes. Implementing a Two Nurses, Four Eyes on Skin Assessment model upon admission and daily during the patient’s stay will decrease the incidence of hospital-acquired pressure injuries.

Purpose: The purpose of this Doctor of …

An Unaddressed Role Of Nurses: Barriers In Promoting Reproductive Health In Pakistan: A Commentary Paper, Rabab Vadivala, Arisha Amin, Sahar Jessani, Sara Hudani

Journal of Asian Midwives (JAM)

Reproductive health has a significant impact on a person’s overall wellbeing. Despite this, it is not given major attention. Many people are still unaware of the importance of reproductive health, and one reason for this is the often-overlooked role of nurses in sexual and reproductive health. Nurses, midwives and lady health visitors are the healthcare professionals that play a pivotal role in promoting reproductive health. However, due to several factors, such as burnout among nurses and a lack of educational preparedness, this role of nurses remains unaddressed. This article discusses the general determinants that contribute to the underutilization of nurses …

Implementation Of A Nurse-Driven Early Mobility Protocol In Critical Care To Reduce Intensive Care Unit Acquired Weakness (Icuaw), Wendy Key

Doctor of Nursing Practice Projects

Background: Intensive care unit acquired muscle weakness (ICUAW) is a syndrome of general weakness that occurs while a patient has a critical illness. Almost half of all ICU patients develop ICUAW. The most common occurrence of ICUAW is seen in patients diagnosed with prolonged mechanical ventilation, severe sepsis, or difficulty weaning from mechanical ventilation (MV). Bedrest is the number one risk factor for the development of ICUAW and the elderly are at higher risk. The best treatment for ICUAW is early mobility which has shown positive effects for decreasing ventilator days and intensive care unit (ICU) length of stay (LOS). …

Maternal Fetal Bonding In Three Trimesters Among Primigravida-A Comparative Study, Sasi Rekha

Manipal Journal of Nursing and Health Sciences

Introduction: Maternal Fetal Bonding is the term used to describe the relationship between the pregnant women and the fetus. A broad spectrum of Maternal Fetal Attachment (MFA) has been observed during pregnancy. The frequency and the intensity of MFA increases with advancing age particularly, after quickening at approximately 18 to 22 weeks of gestation. The aim of this study was to compare the maternal fetal bonding in three trimester. Methodology: Quantitative-evaluative research approach was selected. Non probability convenient sampling technique is used to collect 120 primigravida⁽⁴⁾. Rating scale was used to assess the maternal fetal bonding among primigravida …

Fostering Patient Safety: Importance Of Nursing Documentation, Shamsa Samani, Salma Amin Rattani

School of Nursing & Midwifery

Background: Nurses are professionally accountable for assessing and documenting patients’ vital signs. Nurses failing to fulfill this responsibility position their patients at risk. This paper presents two real-life cases pertaining to patients’ safety resulting in fatal outcomes, leading to the professional, legal, and ethical liability of nurses as the providers of patient care.
Objective: This paper focuses on the role of organizational culture in fostering patient safety specifically in monitoring and documentation of patients’ vital signs and early recognition of warning signs.
Methodology: A comprehensive literature search was conducted using various databases, examining the significance of vital signs monitoring and …

Oxygen Therapy Education To Improve Oxygen Safety In The Emergency Department: A Quality Improvement Project, Latania Wolfe

DNP Projects

Background and Significance: Oxygen is often administered in emergency departments (ED) in US without the nurses and other healthcare staff inputting orders for this medication. This gap in placing orders poses a risk to patient safety and poses a regulation issue.

Purpose: The goal of this quality improvement project is to increase the rate of orders placed for patients using oxygen in ED staff by 12% from March 1, 2023 to May 31, 2023.

Methods: The Model for Improvement guided this quality improvement project. Two PDSA cycles were completed.

Results: PDSA #1 Completed SWOT analysis and used information to …

Michigan Appropriateness Guideline For Intravenous Catheters And The Impact On Utilization And Infection Ratios In Peripherally Inserted Central Catheters, Kasey Smith Bustamante

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adult patients are at increased risk for central line-associated bloodstream infections when central line utilization rates are increased and are inserted inappropriately, based on patient criteria. Purpose: Determine if utilization of the Michigan Appropriateness Guidelines for Intravenous Catheters (MAGIC) will reduce central line utilization ratios (focusing on peripherally inserted central catheters (PICC)) and reduce risk of central line-associated bloodstream infections among an adult population in the Trauma Surgical Care Unit (TSCU) and Medical Intensive Care Unit (MICU) at a tertiary care center in the South Carolina Pee Dee Region. Methods: The Plan Do Study Act (PDSA) quality improvement …

Hpv Vaccine Hesitancy: Improving Vaccination Rates In The Pediatric Primary Care Setting, Stephanie Meltzer Carper

Doctor of Nursing Practice Scholarly Projects

Problem statement: The Human Papillomavirus (HPV) vaccine protects against carcinogenic strains of HPV and is administered during childhood to provide maximum protection during peak risk for exposure and HPV disease. Despite demonstrated efficacy, HPV vaccine hesitancy leads to decreased vaccination rates in the pediatric primary care setting. Purpose: This quality improvement project aims to improve HPV vaccination rates at SouthernMED Pediatrics, Summerville, South Carolina. Methods: A pre-intervention survey was administered to identify parental concerns regarding the HPV vaccine to create a customized educational handout. Health care providers systematically used motivational interviewing, presumptive approach communication techniques, and a customized educational handout …

Retrospective Analysis Of Benzodiazepine And Sedative Use In The Surgical-Trauma Intensive Care Unit, Ronelle Guinyard Goodwin

Doctor of Nursing Practice Scholarly Projects

Problem Statement: There has been an increase in benzodiazepine use and delirium occurrences in the surgical-trauma intensive care unit (STICU). Purpose: This Doctor of Nursing (DNP) project aimed to explore the current practice of benzodiazepine and sedative use for adult patients admitted to the STICU who developed alcohol withdrawal syndrome (AWS) or delirium. Method: A retrospective chart review with descriptive analysis was completed for all adult patients admitted to the STICU at a regional community level 1 adult and level 2 pediatric trauma center, diagnosed with AWS or delirium, and treated with benzodiazepines during their intensive care unit (ICU) stay. …

Improving Communication And Workflow Among Advanced Practice Providers And Nurses On Nightshift In An Intensive Care Unit, Chelsey Alise Durr Massey

Doctor of Nursing Practice Scholarly Projects

Problem Statement: There is often a lack of streamlined communication on nightshift among the reduced care team in acute care settings. The absence of organized collaboration and shared decision-making contributes to strained professional relationships between the advanced practice provider (APP) and the nurse. Purpose: Nightly provider-nurse bedside rounds were implemented in a 21-bed cardiovascular intensive care unit (CVICU) using a goal sheet to improve communication among the APPs and nurses. Methods: A pretest-posttest design in which surveys were used in this quality improvement (QI) project to determine perceptions of communication between APPs and nurses. Inclusion Criteria: All APPs and rotating …

Impact Of A Standardized Checklist On Post Discharge Appointment Attendance And Readmission Rates Of Veterans With A Mental Health Diagnosis, Henretta N. Milton-Williams

Doctor of Nursing Practice Scholarly Projects

Inpatient readmissions are among the most severe problems facing hospitals. Readmissions are most common in the first two to five days after discharge, especially among veterans with mental illnesses at the Columbia Veteran Administration Hospital System (CVAHS) inpatient units. The discharge planning process should begin as soon as a patient is admitted and should be updated throughout the inpatient stay to ensure a safe transition of care from inpatient to outpatient. This Doctor of Nursing Practice (DNP) quality improvement project is aimed to develop and implement a standardized checklist to streamline and organize the discharge planning for all veterans admitted …

Using The Buzzy Device To Decrease Pain, Fear, And Anxiety With Venipunctures And Injections, Lisa Santiago Sauls

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Anxiety, fear, and pain related to initiating peripheral venous access or injections are a high priority in the ambulatory infusion clinic setting for both children and adult populations.

Purpose: To determine if the Buzzy device will decrease anxiety, fear, and pain related to adult patients undergoing peripheral venous access or injections in ambulatory infusion clinics.

Methods: Age, sex, route of medication the patient is receiving. A post-procedure questionnaire assessed the participant's satisfaction with the Buzzy device. Pain, fear, anxiety, and patient satisfaction were all measured using a visual analog scale.

Inclusion Criteria: Patients aged eighteen and above receive …

Implementation Of A Peer To Peer Concussion Management Program And Its Effect On Concussion Knowledge And Reporting Behaviors In Collegiate Club Sports Athletes, Brian Wallace Stefan

Doctor of Nursing Practice Scholarly Projects

Problem: Concussions continue to be a common injury in both athletes and non-athletes across the world. In college, symptoms and recovery time from concussion injuries can lead to loss of social interaction, class time, and participation in school events such as sports. For collegiate club athletes at the University of Pittsburgh, there is currently no mandated concussion protocol, making injury management more difficult. Purpose: This project's purpose was to determine whether a peer-to-peer concussion education tool is a viable implementation option to improve the concussion environment for this population compared to their current structure with no protocol. Method(s): A five-step …

Implementation Of Daily Multidisciplinary Rounding Audits Of Adherence To An Indwelling Catheter Protocol Impact On Catheter-Associated Urinary Tract Infections, Jacqueline April Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Catheter-associated urinary tract infections (CAUTIs) among critical care patients negatively impact the trajectory of the patient’s hospitalization through increased mortality, morbidity, length of stay, and cost. To combat this, hospitals have implemented bundles in compliance with evidence-based practice models to reduce CAUTIs. Purpose: Determine if implementing a daily multidisciplinary rounding audit of established CAUTI prevention protocol decreases the occurrence of CAUTIs in critical care patients with indwelling urinary catheters. Methods: Participants in this quality improvement project included critical care nurses and providers participating in daily multidisciplinary rounds on all critical care patients with indwelling urinary catheters admitted to …

Do Obese Patients Lose Weight After Lumbar Spine Surgery: A Systematic Review And Meta-Analysis, Phillip Vorster, Abhijith V. Matur, Paolo Palmisciano, Fatu S. Conteh, Louisa Onyewadume, Henry Ofori Duah, Geet Shukla, Sai S. Chilakapati, Xu Tao, Sahil Gupta, Sanjit Shah, Benjamin Motley, Joseph Cheng, Justin Virojanapa, Owoicho Adogwa

College of Nursing Faculty Research and Publications

Objective

Obesity is a major health care concern in the United States and is associated with high rates of postoperative complications after spine surgery. Obese patients assert that weight reduction is not possible unless spine surgery first relieves their pain and concomitant immobility. We describe the post-spine surgery effects on patient weight, with an emphasis on obesity.

Methods

PubMed, EMBASE, Scopus, Web of Science, and Cochrane databases were systematically searched according to the PRISMA guidelines. The search included indexed terms and text words from database inception to the date of the search (15 April 2022). Studies chosen for inclusion had …

Analysis Of Couples’ Discordance On Fertility Desire In Ghana, Isaac Yeboah, Joshua Okyere, Henry Ofori Duah, Andrew Kweku Conduah, Mary Naana Essiaw

College of Nursing Faculty Research and Publications

Generally, men in sub-Saharan Africa make reproductive decisions that affect their partners. We examined the predictors of fertility desires among married men across three age cohorts: 20–35 years, 36–50 year, and 51–59 years. Using the 2014 Ghana Demographic and Health Survey dataset, we conducted ANOVA and multivariate binary logistic regressions on 1431 monogamous married men aged 20–59 years. Two indicators of fertility desire are constructed: (i) the comparison of men’s ideal versus women’s ideal family size, and (ii) the desire for more children. The results indicate that the fertility desire of men is stronger than that of women. The predictors …

Design And Implementation Of A Community-Based Mother-To-Mother Peer Support Programme For The Follow-Up Of Low Birthweight Infants In Rural Western Kenya, Jemma Wright, Florence Achieng, Linda Tindi, Manasi Patil, Mwanamvua Boga, Mary Kimani, Hellen Barsosio, Dan Juma, Helen Nabwera, Laura Kiige

Obstetrics and Gynaecology, East Africa

Background: Globally, low birthweight (LBW) infants (

Methods: Key informant interviews were conducted with 10 mothers of neonates (infants days) from two rural communities in western Kenya. These data informed the identification of key characteristics required for mother-to-mother peer supporters (peer mothers) following up LBW infants post discharge. Forty potential peer mothers were invited to attend a 5-day training programme that focused on three main themes: supportive care using appropriate communication, identification of severe illness, and recommended care strategies for LBW infants. Sixteen peer mothers were mentored to conduct seven community follow-up visits to each mother-LBW infant pair with fifteen …

Parenting During A Pandemic: Understanding The Impact Of Covid-19 On Early Childhood Development, Jessica A. Manes

Senior Theses

The early years of a child's life are crucial for their development, shaping their ability to process information, communicate, and form their identity. However, the COVID-19 pandemic disrupted essential elements necessary for optimal early childhood development, including quality education, nurturing environments, and social stimulation. This study explored how parents in South Carolina perceived the pandemic's impact on their children's development. Five themes emerged from the study. Firstly, remote work due to pandemic protocols significantly affected the parent-child relationship. Secondly, the family's socioeconomic status influenced their ability to cope with and protect their children from the pandemic's impact. Thirdly, isolation resulting …

Care Labour Shortage Needs A Cure, Not More Band-Aids, Yasmin Y. Ortiga

Asian Management Insights

Retaining care workers will become more difficult for Asia’s ageing economies.

Editorial - Summer 2023, Edwin Van Teijlingen, Rafat Jan, Kiran Mubeen, Abeer Musaddique

Journal of Asian Midwives (JAM)

No abstract provided.

Labor Companionship: A Concept Of Doula Care: A Commentary Paper, Arisha Amin, Rabab Vadivala

Journal of Asian Midwives (JAM)

A labor companion is a person who offers consistent individualized support to laboring women. Doula care is defined as the care which an individual provides of physical, social, and emotional support during pregnancy, labor, birth, and the postnatal period (1). Doulas help women ease their anxiety, and pain and address their concerns with comfort, care, and respect. Doulas help in cherishing a mother and child bonding helps in initiate breastfeeding and provide an emotional bond throughout the birthing time. It helps in reducing cesarean sections, and high-risk pregnancies and minimizes infant and maternal mortalities. The purpose of the study is …

Bangladesh To Take Over The Training Of Midwifery Educators: A Commentary Paper, Kerstin Erlandsson, Ulrika Byrskog, Catrin Borneskog Sinclair, Christina Pedersen

Journal of Asian Midwives (JAM)

While Bangladesh has made gains in maternal health provisions, there are still gaps and unmet need for services. Bangladesh has trained over 7 000 midwives, and many more midwifery educators are needed to serve the country’s population of 140 million with midwifery services. In April 2016 the first nursing faculty teaching midwifery students at nursing institutes across Bangladesh were enrolled in a blended online and onsite master’s programme with the Dalarna University, Sweden. The programme content focused the subject sexual, reproductive and perinatal health and was the first of its kind in Asia. The graduating faculty members were expected to …

Is It Safe To Have Sexual Intercourse During Pregnancy? A Commentary Paper, Misbah Zafar, Mehreen Aslam

Journal of Asian Midwives (JAM)

Sexuality is an expression of love, care, and intimacy between couples but pregnancy, and the early postnatal period can have a significant impact on sexual health. Numerous physiological and psychological changes take place during pregnancy^[1]. These changes may have a deep influence on the sexual lives of married couples in a variety of ways. ^[2]

The degree of sexual health awareness, myths, rituals, and beliefs about sexual activity during pregnancy are some of the contributing factors which promote or hinders the sexual relationships during pregnancy ^[3]. The most common fear related …