Nursing Commons^™

Effectiveness Of Perioperative Ketorolac Versus Opioids: A Scoping Review, Jamie Smith Bsn, Srna, Ashley Warner Bsn, Srna, Oran Tubre Bsn, Srna, Sherman Stauffer Bsn, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Abstract

Purpose

The purpose of this project will compare the effectiveness of ketorolac over opioids alone for pain management of patients 72 hours postoperatively.

Background

In recent years, there has been overwhelming evidence of opioid abuse and its adverse effects on patients’ lives. To combat this, significant attention has been paid to multimodal analgesia throughout the perioperative period to decrease patients’ exposure to opioids. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ketorolac, are being administered intraoperatively to reduce the need for opioids in patients' post-surgical procedures.

Methods

A literature review was done on articles that evaluated perioperative adult human patients undergoing …

The Importance Of Education About Juvenile Diabetes, Sarah Cutcher

Honors College Theses

Juvenile diabetes occurs when a patient under the age of 18 has an abnormally low amount of insulin in his/her body. This is due to the destruction of the insulin producing cells. There are two different types of diabetes, but they both have different risk factors that could lead to the diagnosis of type 1 or type 2 diabetes. A diagnosis of diabetes does not only mean that one has to manage this chronic disease, but the patient will now have an increased risk of developing complications later in life. Some examples of these complications are heart disease, skin integrity …

Mapping Psychological Safety In The Nursing Classroom: A Situational Analysis, Lori Beth Beard

Theses and Dissertations

The purpose of the qualitative situational analysis was to explore the interconnectedness of human and non-human elements that shape psychological safety in the associate degree nursing classroom learning environment. Using grounded theory methods together with situational analysis, specifically situational mapping, a theory of psychological safety in the nursing classroom emerged from the data. The data highlighted several theoretical categories that capture how faculty use various elements to construct psychological safety in the classroom. From the data emerged the theory that nurse faculty connect their nurse identities to the elements when building psychological safety into the classroom learning environment. Implications for …

Impact Of Culturally Tailored Shared Medical Appointments On Diabetes Self-Care Ability And Knowledge In African Americans, Adrienne L. Reddick, Deborah C. Gray

Ellmer School of Nursing Faculty Publications

Background: Type 2 diabetes mellitus (T2DM) continues to disproportionately affect African Americans, significantly impacting morbidity and mortality. Research suggests that addressing barriers that stem from socioeconomic circumstances, systemic inequalities, biological factors, and cultural factors may positively influence biometric indicators of health and diabetes control. Objective: The aim of this study was to evaluate a diabetes shared medical appointment (SMA) model program that has been culturally tailored to address the unique social determinants of health barriers faced by an inner city African American population in Norfolk, Virginia. Methods: A pilot study using a within-group pretest–posttest design was conducted. Information was collected …

Trauma Team Communication During Trauma Resuscitation: A Literature Review, Paula Barney

Student Works

Trauma teams nationwide are tasked with stabilizing and treating severely injured patients. Their work is unpredictable and must be carried out quickly to improve patient outcomes. Effective team communication is imperative. Team members communicating to form shared understanding of patient status and care goals supports high-level team function. Clear communication is essential. Team members should use closed-loop communication when appropriate, use brief and direct statements, and limit noise in trauma rooms. Team leaders support trauma team performance by providing updates on patient status and plans of care and fostering a culture of collaboration between team leaders and team members. Team …

Wellness Review 2022, Part 2, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: Similar to prior reviews, the Journal of Wellness editors searched the literature from the second half of 2022 for an interesting and impactful selection of publications on wellness in healthcare professionals.

Methods: Editors conducted a standard keyword search in Pubmed, focusing chiefly on large journals, interventional trials, and other prospective research. We included papers published between July 1, 2022 and December 31, 2022.

Literature in Review: Finding several hundred publications, we excluded editorials, reviews, and some smaller, less generalizable papers. A final 25 significant studies focusing on wellness in medical professionals were sorted into the following categories: logistics, creativity …

Effect Of Virtual Dementia Tour On Prelicensure Student Nurses’ Attitudes Towards Dementia Care: A Quantitative Study Protocol, Kevin Alton

Symposium of Student Scholars

Background: With over six million Americans currently living with dementia, it is crucial for prelicensure nursing programs to prepare registered nurses to provide quality care to individuals with dementia and their caregivers. Due to the challenges associated with providing face-to-face clinical experiential learning, particularly during the COVID-19 pandemic, virtual simulation approaches are now being used as alternative or complementary clinical experiential teaching/learning methods.

Design: Quantitative Research

Purpose: To evaluate the effectiveness of the Virtual Dementia Tour on prelicensure student nurses' attitudes towards dementia care.

Methods: This study is nested in a larger ongoing multisite, mixed-methods crossover-experimental designed study that investigates …

Postpartum Health And Wellbeing, Tamara Black

Symposium of Student Scholars

Our project is testing the stress levels of women in postpartum. We developed surveys for women who have recently given birth and then do a two finger stress test.

How Covid-19 Has Affected The Hand Hygiene Habits Of Healthcare Majors And Non-Healthcare Majors, Anna Kate Mcdaniel

Merge

The research hypothesis states there is a statistically significant difference in how Covid-19 affected the hand hygiene habits of healthcare majors and non-healthcare majors. The research study utilized survey which students completed at the cafeteria of a small liberal arts college in the southeastern United States. The population assessed were students who entered the cafeteria while the survey was being administered and agreed to complete the survey. The results of the survey determined there is no statistically significant difference in how Covid-19 affected the hand hygiene habits of healthcare majors and non-healthcare majors. An important implication for the healthcare majors …

The Effectiveness Of Increasing Frequency Of Central-Line Dressing Changes And Monitoring On Clabsi Rates: A Scoping Review, Jacob Schmidt, Bsn, Rn, Ccrn, Georgia Brown, Bsn, Rn, Laura Dickey, Agpcnp-C, Lauren Faulkner, Bsn, Rn, Margaret Harvey, Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Abstract

Purpose/Background

Central lines provide many benefits to critically ill patients; however, there are additional risks with them, including central line-associated bloodstream infections (CLABSIs). CLABSIs place patients at increased risk for morbidity and mortality, longer length of stay, and higher medical costs. Studies evaluating various methods of reducing CLABSIs have been performed. This scoping review was completed to determine the effectiveness of frequent central-line dressing changes and increased monitoring on the incidence of central-line associated blood stream infections in adults with central-lines.

Methods

An extensive database search through the University of Tennessee Health Science Center (UTHSC) Online Library was performed …

Teach-Back Method To Reduce Chf Readmissions: A Scoping Review, Briyanna Evans Bsn, Rn, Bre'yocha Dewalt Bsn, Rn, Ccrn, Jessica Mabry Bsn, Rn, Kailee Garrett Bsn, Rn, Crystal Stephens Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to evaluate the effectiveness of the teach-back method on education as it relates to congestive heart failure readmission rates. Congestive heart failure (CHF) is the most common cause of hospitalizations among those 65 years and older in the United States. CHF readmission rates in Tennessee are higher than the already elevated national average. The current literature suggests a need to reduce 30-day readmissions, improve patient outcomes, and enhance self-efficacy in patients with CHF. The research proposes a correlation between high readmission rates and poor knowledge retention of patients with CHF, but small …

Revising The Team Huddle Process In A Federally Qualified Health Center, Donna Demann

Masters Projects

Abstract Background: Interdisciplinary team collaboration is a component of the patient centered medical home (PCMH) and can be met by completion of a daily team huddle (DTH). Local Problem: A federally qualified health center (FQHC) requested help revising the team huddle process to make it more beneficial for staff and patients. Goal was to improve team cohesion, collaboration, and communication and ultimately improve patient outcomes. Methods: The problem was addressed through revision of the huddle process. Process changes were guided using the actions from an evidence-based huddle framework and implementing additional teamwork strategies. Interventions: This project reconstructed the current huddle …

Type 2 Diabetes Nutrition: A Video-Based Education Approach, Erin Russell

Masters Projects

Background: Type 2 diabetes mellitus (T2DM) is a chronic disease associated with life- threatening outcomes. To prevent such outcomes, people with diabetes must possess the knowledge and skills required to manage their chronic disease. Objectives: To evaluate the impact of video-based education (VBE) on participant Diabetes Self-Management Education Skills (DSMES). Methods: The experimental study was conducted in a primary care office in a Midwest state. A convenience sample of 55 participants was selected. Pre- and post-implementation surveys were administered to measure change in self-efficacy between DMSES scores after viewing the VBE intervention. The Wilcoxon Rank Sum test was performed using …

Improving Adherence To Annual Retinal Screening Among Adult Diabetics In Rural Midwest, Sarah Hunger

Doctoral Dissertations & Projects

Background: Diabetic retinopathy (DR) affects millions of people worldwide and is a main cause of preventable blindness. Experts recommend annual retinal screenings on all diabetic patients. Studies show continuing trends of non-adherence, as well as significant barriers to screenings. Recommendations to overcome barriers and methods to improve adherence among diabetics are topics of interest among healthcare providers. The purpose of this project was to increase annual retinal screening adherence among adult diabetics at a privately owned primary care practice in the rural Midwest.

Methods: Staff and 59 patients, chosen through convenience sampling were involved. Pre- and post- implementation surveys were …

Defining Success In Patient Care Technician Development, Ferrol A. Thomas

DNP Projects

The national nursing shortage has created a need for unique staffing models in healthcare organizations that incorporate unlicensed assistive personnel such as, patient care technicians (PCT). As part of the healthcare team, PCTs provide support to registered nurses contributing to positive patient outcomes. Recruitment and training for PCTs is successful in workforce development programs through employer academic partnership programs. The Success Case Method (SCM) was used to evaluate a local workforce development program for PCT at Nashville State Community College. Participants were evaluated to gain demographic data (n=25) and qualitative interviews (n=6) to provide insight about what made the program …

Effect Of Covid-19 On Icu Nurse Burnout, Kayce Sheppard

Honors College Theses

Burnout is becoming increasingly worse for those in the nursing field after the height of the COVID-19 pandemic. While all nurses are at risk, ICU nurses are seen as at a higher risk for this increased burnout due to the already high stress environment they are subjected to in their unit. Without proper intervention of this issue, the levels of burnout are expected to continue to remain high, leading to job dissatisfaction, short staffing, and reduced patient satisfaction. The objective of this study is to review the level of burnout among ICU nurses. A burnout study was conducted on ICU …

Non-Fatal Strangulation During Sexual Assault: A Retrospective Review, Brooke E. Stacey

Theses and Dissertations

Background: Non-fatal strangulation (NFS) is a life-threatening event in cases of sexual assault. The incidence of NFS during sexual assault is increasing on a global scale. NFS is a gendered crime as most victims are women and most assailants are men and is more common in intimate partner violence. Strangulation victims only have visible neck injuries around 50% of the time, but visible injuries are not a reliable indicator of the severity of the assault. NFS can cause neurological damage from lack of blood flow to the brain and result in physical and psychological trauma. NFS indicates a high degree …

Addressing Health Illiteracy In The Hispanic Community – A Call To Action: An Integrative Review, Sarah Akers Dersch

Doctoral Dissertations and Projects

The United States Hispanic population is rapidly growing; however, existing healthcare endeavors are insufficiently accommodating this expansion. This demographic is linked to multiple serious health problems, including obesity, diabetes, hypertension, cardiac disease, cancer, and liver disease. In order to improve health outcomes within this community, interventions, such as health literacy screening, need to be further explored to identify current insufficiencies and help this population overcome these health challenges. This integrative review seeks to determine the effectiveness of current health literacy screening tools among native Spanish speakers in the U.S. This review seeks to amalgamate data from various studies to demonstrate …

How Does Obstetric Simulation Impact Undergraduate Pre-Licensure Bsn Student’S Clinical Judgement Related To Using And Understanding Fetal Monitoring?, Brandy Leona Clayton

Doctoral Dissertations and Projects

Obstetric simulation can impact undergraduate prelicensure Bachelor of Science in nursing (BSN) students’ clinical judgment related to using and understanding fetal monitoring. The purpose of this study aimed to determine if a relationship exists between a student's obstetrical simulation practice and increased knowledge gained for fetal monitoring interpretation. Simulation practice provides a tangible way to test knowledge and competency, but is there an effect on student learning with the knowledge and understanding of fetal monitoring, and can simulation practice create that knowledge? A purposive sample of 24 undergraduate prelicensure BSN nursing students, within their obstetrical course, with the intent to …

Does Competency-Based Educational Elearning Improve Medical Assistant Knowledge And Performance In Blood Pressure Measurement And Recognition Of Elevated Bp Readings?, Janice Burkybile

Anna Vaughn School of Nursing Doctor of Nursing Practice (DNP) Projects

Inaccurate blood pressure measurement techniques can severely impact patient health, from missed diagnoses to medical mismanagement with the potential development of cardiovascular disease and chronic kidney disease. Researchers have reported for decades that all skill levels of healthcare providers perform inaccurate blood pressure measurement techniques. This problem can be attributed to one-time instruction with no refresher follow-up and no standardization of technique. Competency-based education facilitates healthcare providers to achieve competency in knowledge and performance of learned new skills and refresher training. Ultimately, competency-based education develops lifelong learners resulting in improved patient outcomes. The educational intervention was a thirty-minute eLearning codeveloped …

Instilling Parental Confidence Through Text-Linked Educational Modules At 6 And 24 Weeks, Rachel Hage

Honors Scholar Theses

Background: Becoming a parent is one of the most demanding and intense social roles individuals can experience in their life (Vance & Brandon, 2017). A lack of maternal confidence and understanding of how to interact with their infant during the first six months of life may adversely affect their lifelong relationship.

Objective: To examine maternal descriptions of text-linked educational modules on infant development and play and their effect on maternal self-efficacy at 6 and 24 weeks.

Method: This study was a mixed-method approach of interviews collected as part of a larger randomized control intervention for mothers to manage their breast …

Do-Not-Hospitalize Orders In Assisted Living Facilities: Perspectives From Direct Care Workers, Alanna Kates Dancis Dr.

Doctor of Nursing Practice Scholarly Projects

Context: Do-not-hospitalize (DNH) orders in assisted living facilities (ALFs) are often misunderstood, ignored, or countermanded by direct care workers (DCWs), potentially leading to residents being sent to the hospital against their wishes.

Objectives: The primary purpose of this study was to gather sufficient qualitative data to create an intervention that would help prevent DCWs from sending residents with DNH orders to the hospital against their wishes. To accomplish this goal, the study centered on three research objectives: 1) to understand more fully how DCWs interpret DNH orders; 2) to determine if carrying out DNH orders causes moral distress for DCWs; …

A Systematic Record Review Of A Local Quality Improvement Impacts On Anesthesia Provider Knowledge And Attitudes Following A Presentation Of Current Evidence-Based Practices Involving Intrathecal Mepivacaine Use In Total Joint Arthroplasty Surgical Patients, Kevin Mcclellan

Doctor of Nursing Practice Scholarly Projects

Abstract Patients undergoing spinal anesthesia for total joint arthroplasty (TJA) must urinate and ambulate within 1-hour before discharge from the post-anesthesia care unit to indicate a healthy return of lower body neuro-function after spinal administration. The most common spinal medication used is bupivacaine which has complications including postoperative urinary retention (POUR), altered proprioception, delayed ambulation, and prolonged motor block, resulting in increased cost and length of stay. One alternative solution is mepivacaine, an intermediate local anesthetic lasting 1.5 to 2.5 hours with comparative surgical blockade but a quicker motor and sensory function return. Research suggests mepivacaine is just as safe …

Use Of External Uterine Electromyography Across Stage I Labor, Rebecca Benfield, Edward R. Newton

Nursing Faculty Research

Introduction: Highly sensitive, external uterine electromyography (EMG) measures myometrial electrical activity and is noninvasive compared with the clinical intrauterine pressure catheter. Most experimental studies have measured EMG in 30-minute epochs, limiting the utility of this instrumentation in intrapartum clinical practice. To test proof of concept, surface uterine EMG contraction activity was continuously collected throughout the first stage of labor from healthy women at term gestation with (n = 3) and without (n = 1) epidural or combined spinal-epidural analgesia for a maximal length of 11 hours and 24 minutes.

Methods: EMG activity was recorded concurrently with tocodynamometer (toco) signals, using …

Efficacy Of Distraction Therapy In Reducing Needlestick Pain In Pediatrics: A Scoping Review, Ashlan Ritchie Bsn, Rn, Anne Evans Bsn, Rn, Charlotte Isabel Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn, Bmtcn

Doctor of Nursing Practice Projects

Purpose/Background

Pediatric pain management is often overlooked due to time constraints and lack of resources or education on interventions used, such as distraction or pharmacological therapy. Lack of pain management leads to patient and caregiver distress, as well as an increased number of attempts to perform the procedure. This scoping review evaluates the efficacy of distraction therapy compared to nonopioid pharmacological interventions for acute needlestick pain in children ages 6 to 12 years; patient and caregiver levels of distress were also evaluated in most studies.

Methods

The UTHSC (University of Tennessee Health Science Center) Library database was searched for full-text …

Effects Of Guided Journaling On Nursing Clinical Judgment During An Externship, Jaclyn Parrill

Undergraduate Theses

Background: There is longstanding discussion concerning the competency of novice nurses who passed the National Council Licensure Exam (NCLEX) and their ability to practice safely. Nursing clinical judgment (CJ), also known as critical thinking or clinical decision-making, accounts for more than 46% of daily tasks nurses perform in their first year (Hensel, 2020, p. 128). Guided reflective journaling is one active learning strategy that encourages students to reflect on what they have learned, anticipate future needs, and enhance clinical judgment skills (Meijer, 2021, p. 9, 11). This qualitative pilot study follows one nursing student throughout a student nurse extern program …

The Utilization Of Depression Screening Tools In Patients With Diabetes Type 2, Hanna Book, Kennedy Eldridge, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Artangela Henry Dnp, Agacnp-Bc, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting. …

Examining The Need For Change By Describing The Attitudes And Perceptions Of Team Communications Related To Patient Care And Safety Among Ambulatory Clinic Healthcare Staff, Peter Seivers

Doctor of Nursing Practice Scholarly Projects

Medical errors account up to 250,000 patient deaths annually. Research suggests medical errors are attributable to poor healthcare team communications. The Institute of Medicine posits that communication and teamwork are essential components to safe and successful health care environments. According to the Joint Commission poor communication is considered the root cause of nearly 80% of all serious medical errors. Consequently, the Department of Defense and Agency for Healthcare Research and Research created a team-based training program, known as TeamSTEPPS®, which has shown to improve team communication, performance, effectiveness, patient safety, satisfaction, and health outcomes in healthcare settings. Despite evidence supporting …

Improved Bonding & Maternal Self-Efficacy In The Nicu: A Scoping Review​, Alexandria Sneed Nauert Bsn, Rnc-Nic, Mckenleigh N. Hill Bsn, Rnc-Nic, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Mothers of infants admitted into the neonatal intensive care unit (NICU) are at risk for developing anxiety, depression, and post traumatic stress disorder (PTSD) related to their child’s hospitalization which impedes the mother-infant bonding and attachment process. Research shows that children of mothers suffering from these issues are more likely to develop their own behavioral, emotional and cognitive problems later in life. The purpose of this scoping review is to analyze the literature regarding methods to improve bonding and attachment between NICU patients and their mothers to improve long-term outcomes for the whole family.

Methods

The authors conducted a …

Virtual Visits In Routine Prenatal Care, Katrina K. Wu

MUSC Theses and Dissertations

Problem

One million pregnant persons in the United States do not receive early prenatal care or the recommended number of prenatal visits each year, and this gap in care access disproportionately affects people of color, those with lower incomes, and those living in rural communities. Telemedicine was widely utilized in prenatal care during the COVID-19 pandemic, and optimizing prenatal telemedicine has the potential to improve prenatal care access beyond the pandemic.

Purpose

This dissertation focused on examining the integration of virtual visits in routine prenatal care during the COVID-19 pandemic. The purpose of this dissertation was to:

Aim 1. Explore …