Nursing Commons^™

Implicit Bias Training In The Student Nurse Practitioner’S Curriculum, Macdana Selecon

DNP Qualifying Manuscripts

Background: Implicit bias (IB) training is not provided in all graduate nursing programs. As a result, graduate nursing students are not prepared to address poor health outcomes related to healthcare biases. This literature review examines the evidence for effective IB training methodologies.

Methods: CINAHL, Fusion, PubMed, Google Scholar, and Cochrane Database of Systematic Reviews were searched for peer-reviewed articles published between 2010 and 2022. The identified studies were critically appraised using the Johns Hopkins Nursing Evidence-Based Practice Level and Quality Guide Tool.

Results: Six articles were identified as eligible. Five studies implemented implicit bias training for graduate nursing students and …

Putting All My Eggs Into The App': Self, Relational And Systemic Surveillance Of Mothers' Use Of Digital Technologies During The Transition To Parenting, Jodi Hall, Bradley Hiebert, Danica Facca, Lorie Donelle Phd, Rn, Fcan

Publications

This paper builds on thematic findings from a larger study that explored how digital technologies (e.g. smartphones, apps, search engines) shape expectant and new mothers' early parenting practices. An overarching theme that arose across these mothers' experiences which deserved deeper exploration was relational digital surveillance. In the context of this paper, relational digital surveillance describes how mothers evaluate their sense of preparedness, goodness or suitability for motherhood as they transition into parenting in relation to: their own use of digital technologies when caring for their pregnant bodies (self-surveillance), partners' and family members' commentary and/or judgement regarding their use of digital …

Parental Contextual Factors And Decision-Making Related To Periviable Birth: An Integrative Review, Amy L. Wright, Elizabeth Mens, Gausiha Rathitharan

The Qualitative Report

Parents facing a periviable birth, or birth before 25 weeks of gestation, commonly engage in antenatal consultation with healthcare providers to determine a plan of care. Parents’ pre-existing contextual factors, beliefs, and values influence their decisions regarding birth and the care of their infant. This study aims to understand the role of parental contextual factors and best-practices to their integration during antenatal consultation The Whittemore and Knafl (2005) approach to conducting an integrative review along with thematic analysis was employed to determine and present the findings. Results describe three themes related to how contextual factors influence parental decision-making: personal values …

Optimizing Your Capstone Experience: A Guidebook For Allied Health Professionals, Virginia E. Koenig

Open Touro Created

2023

This guidebook is designed for allied health professional students. Each chapter in this guidebook provides students with useful information, tools, and examples that will support them before, during, and after their capstone journey. This is a one of a kind resource that can be used in a variety of professional academic settings. The primary goal of this guidebook is to support students throughout their capstone experience and to help them understand how the capstone process will enrich both their personal and professional advancement.

Breast Milk Jaundice (Nursing), Stephanie Bratton, Rebecca M. Cantu, Mitchell Stern, Wanda Dooley

Nursing and Health Sciences

No abstract provided.

Review Of Storytelling In Queer Appalachia: Imagining The Unspeakable Other, Sandra L. Cotton Dnp, Rn, Anp-Bc, Fnap, Laurie A. Theeke Phd, James Messer

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of residents of Appalachia. Improving the health in the region of Appalachia means knowing our people as they live and thrive in communities. The book reviewed here, Storytelling in Queer Appalachia: Imagining the Unspeakable Other (Edited by Glasby, Gradin, and Ryerson), is a must read for people who wish to gain insight on the real experience of being queer in Appalachia.

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.

A Quality Improvement Project To Reduce Rates Of Deep Sternal Wound Infections Among Adult Cardiovascular Surgery Patients With A Sternotomy Approach, Cole Gatzke, Samantha Porcher

Nursing DNP Projects

Background: An increase in deep sternal wound infections (DSWI) within the cardiovascular surgery (CVS) department at a large midwestern teaching hospital among adult patients with an open sternotomy approach. Objective: To reduce the DSWI rate within the hospital’s CVS department. Methods: After gathering stakeholder input and observing the perioperative process, an extensive review of current literature was conducted to address the problem. Interventions that had literature support were then reanalyzed with stakeholder input for implementation selection, along with a cost-benefit analysis. A pilot was designed applying the Posthorax™ Pro Sternal Support Vest for adult cardiac surgery patients with a sternotomy …

Decreasing Restraint Use By Utilization Of Agitation Assessment And Verbal De-Escalation Strategies In An Inpatient Non-Psychiatric Hospital, Kiera Paulo

DNP Qualifying Manuscripts

Background: This paper reviews the literature on ways to decrease the use of restraints in hospitals – specifically the use of agitation assessments and verbal de-escalation to be implemented in healthcare facilities to decrease the number of restraints being used to manage undesirable patient behavior and workplace violence incidents. Problem: Restraints have been shown to impede the nurse-patient relationship and cause emotional and physical trauma to staff and patients. They are no longer considered preferred management and in some circumstances can be considered abuse. Intervention: Agitation assessments and verbal de-escalation have been shown to produce less aggressive behavior and decrease …

Metabolomics Of A Neonatal Cohort From The Alliance For Maternal And Newborn Health Improvement Biorepository: Effect Of Preanalytical Variables On Reference Intervals, Lena Jafri, Aysha Habib Khan, Muhammad Ilyas, Muhammad Imran Nisar, Javairia Khalid, Hafsa Majid, Aneeta Hotwani, Fyezah Jehan

Department of Pathology and Laboratory Medicine

Background: The study was conducted to determine reference interval (RI) and evaluate the effect of preanalytical variables on Dried blood spot (DBS)-amino acids, acylcarnitines and succinylacetone of neonates.
Methodology: DBS samples were collected within 48-72 hours of life. Samples were analyzed for biochemical markers on tandem mass spectrometer at the University of Iowa. Comparison of RI across various categorical variables were performed.
Results: A total of 610 reference samples were selected based on exclusion criteria; 53.2% being females. Mean gestational age (GA) of mothers at the time of delivery was 38.7±1.6 weeks; 24.5% neonates were of low birth weight and …

The Relationship Between Endotracheal Tube Different Cuff Pressure Measurements And The Incidence Of Ventilator-Associated Pneumonia, Menattallah Mohamed

Nursing

Endotracheal tube cuff pressure measurement is an essential practice for management of mechanically ventilated patients. Based on guidelines, it’s recommended to maintain the endotracheal tube cuff pressure within a range between 20-30cm H2O. When the endotracheal tube cuff pressure is lower than the normal range, it increases the risk of micro-aspirations and the passage of contaminated secretions of the oral cavity into the trachea; this potentially causing aspiration pneumonitis and ends with ventilator associated pneumonia. This study aimed to assess the relationship between endotracheal tube different cuff pressure measurements and the incidence of ventilator associated pneumonia. A non-randomized descriptive correlational …

Screenings To Decrease Pediatric Suicide, Jordan Bridges, Dana Schildmeyer, Amanda Austin, Laura Boesken

Posters-at-the-Capitol

This project aimed to examine the current practice related to mental health and depression screenings in pediatric patients. The benefits of implementing screening in schools in identifying depression and suicide risks sooner were also considered. This project focused on the correlation between earlier mental health screening and identification of these mental health disorders earlier in the life of pediatric patients and suicide rates. Current, published literature notes mental health screening in the pediatric population in schools is an effective method to facilitate monitoring and early intervention in detecting a mental illness. Schools implementing mental health screenings can result in increased …

Home Visitation To Prevent And Reduce Postpartum Depression, Anna Bauer, Madison Polley, Laura Boesken Dnp, Msn, Rn

Posters-at-the-Capitol

Postpartum depression (PPD) occurs in 13-19% of women worldwide, and is a stigmatized medical condition affecting maternal and infantile long term outcomes. The purpose of this evidence-based practice project was to determine if women at high risk for PPD are affected by home visitation programs from discharge up to three years postpartum. CINHAL Ultimate, Google Scholar, and Medline databases were used. Current evidence supports the use of home-visitation programs for postpartum women to decrease the prevalence and the symptoms of PPD by allowing nurses access into homes to provide early intervention for PPD. In addition to providing care for prevention …

A Flexible Pressure Sensor With Highly Customizable Sensitivity And Linearity Via Positive Design Of Microhierarchical Structures With A Hyperelastic Model, Zhenjin Xu, Dezhi Wu, Zhiwen Chen, Zhongbao Wang, Cong Cao, Xiangyu Shao, Gang Zhou, Shaohua Zhang, Lingyun Wang, Daoheng Sun

Publications

The tactile pressure sensor is of great significance in flexible electronics, but sensitivity customization over the required working range with high linearity still remains a critical challenge. Despite numerous efforts to achieve high sensitivity and a wide working range, most sensitive microstructures tend to be obtained only by inverting naturally existing templates without rational design based on fundamental contact principles or models for piezoresistive pressure sensors. Here, a positive design strategy with a hyperelastic model and a Hertzian contact model for comparison was proposed to develop a flexible pressure sensor with highly customizable linear sensitivity and linearity, in which the …

Using Doctoral Education And Research-Based Learning To Advance The Nurse Leader, Kara R. De La Fosse

The Journal of Advancing Education Practice

Nurse leaders perform in highly autonomous positions in two dimensions; academia, and the clinical setting with the awesome responsibility to serve and protect others. To guide nursing practice, research-based skills are crucial to ensure leadership decisions are founded in evidence-based practice. Random controlled studies are gold-standard in healthcare compared to correlation or descriptive studies and employ a systematic review to strengthen findings (Schmidt & Brown, 2021). Research skills are prominent in numerous components of the leadership scope to perform at a stellar level.

Ur-Ine Good Hands In The Neuroscience Intensive Care Unit, Molly Lehatto, Courtney Hastings, Monika Mehlbrech, Christina Szabo

VCU Health Nursing

Purpose:

The purpose of this performance improvement project was to decrease the harm to patients related to catheter associated urinary tract infections (CAUTIs) in the Neuroscience Intensive Care Unit (NSICU). Historically, the NSICU had the highest CAUTI rates in our organization with as many as 6 CAUTIs per calendar year quarter. A core group of nurses partnered with providers, hospital infection preventionists and nursing leaders to improve practices for placing, removing, and managing urinary catheters and to implement guidelines for urine testing stewardship.

Description:

Significance: In 2020, the NSICU had 12 CAUTIs, the highest number of CAUTIs in the entire …

Wound Care Training Using Simulation: Impacts On Clinical Knowledge, Skill Performance, And Satisfaction Among Skilled Nursing Facility Staff, Anna Sue Moody, Vorachai Sribanditmongkol

College of Health Sciences Posters

Impaired skin integrity, wound formation, and infections are significant health concerns. Therefore, competent wound care is essential for skilled nursing facility residents in long-term care. To recoup losses sustained during the COVID-19 pandemic, one skilled, nursing facility in North Carolina increased admissions from other facilities from 59% to 68%, which resulted in a surge of residents with pre-existing and complex wounds. High staff turnover and inconsistent wound care practices were also observed. Research suggests that healthcare institutions with high attrition may experience degradations of clinical knowledge, skill proficiency, and safe, quality nursing care delivery. Evidence supports the use of simulation-based …

Accelerated Onboarding For Unlicensed Personnel When Preceptors Are Limited, Britney Winkelman

Nursing Posters

Problem:

The timeframe between hiring unlicensed personnel (UP) to beginning the role within the organization began to increase due to limited orientation resources, rising staff shortages, and insufficient number of preceptors.

Purpose:

Accelerate the onboarding of UPs to decrease the workload for preceptors and reduce staff shortages, while generating competence and reducing costs for the organization.

Clinical Nurse Specialists: A Rare Breed, Teresa Jahn, Evalyn Michira, Elizabeth Plante

Nursing Posters

What is a CNS?:

• A clinical nurse specialist (CNS) is an advanced practice registered nurse (APRN) with graduate level education in nursing.
• CNSs are prepared to provided leadership, consultation, and clinical expertise for patients and their families, nurses, and systems.
• Have the autonomy to diagnose and treat based on advanced clinical assessment like other APRNs (Nurse practitioners, certified nurse midwives, certified registered nurse anesthetists).
• CNS work in all areas of healthcare like clinics, emergency departments, hospital units, entire healthcare systems, or even as independent practitioners/contractors.

Icu Cauti Incidence Reduction, Michelle Gamble

Nursing Posters

Situation:

Catheter-Associated Urinary Tract Infection (CAUTI) rates in the adult Intensive Care Unit (ICU) increased from nine infections in FY21 to 18 in FY22.

Backgroud:

CAUTIs are the most reported healthcare acquired infection. It is important for healthcare providers to understand the complications and effects of CAUTIs. CAUTIs contribute to extended length of stay, increased healthcare costs, and patient morbidity and mortality.

Most CAUTIs are directly related to inadequate urinary catheter care. Evidence based practice demonstrates a decrease in CAUTIs related to the use of Theraworx^® Protect wipes twice daily (BID) and as needed (PRN) for patients with a …

Pupillometry, Elizabeth Plante, Casey Schmidt

Nursing Posters

Background:

• Measuring pupillary light reflex is a standard part of neurological assessment.
• Changes in pupil reactivity may indicate unfavorable outcomes, such as increased intracranial pressure and brain herniation.
• Physiologic and pharmacologic agents may affect pupil reactivity.
• In some instances, pupillary light reflex is the only piece of neurologic assessment readily testable.

What I Need: Self Care At The Unit Level, Jessica A. Tindal

Nursing Posters

Purpose:

Self-care is individualized and best done when awarded on a small scale.

Goals:

For all employees of the ICU to:

• Feel valued outside of work
• Be recognized for taking care of themselves
• Participate in positive discussions
• Be rewarded for work life balance
• Be reminded of self-care
• Not feel alone with their thoughts
• Pause and reflect
• Help others, spouses, kids, etc.

Future plans include:

• Seasonal questions of things to see, places to explore
• Recipe sharing
• Hobby experts
• Focusing on staffs' interests

Safe Intra-Hospital Transport Of Adult Patients On Non-Critical Care Units, Teresa Jahn, Janelle Maciej, Greta Titus

Nursing Posters

Plan:

Between 2021 and 2022, two non-critical adult patients returning from the imaging department after an invasive procedure developed increased oxygen needs, which ended in death for on patient and a transfer to critical care for the other.

No formal guidelines exist for the intra-hospital transport by unlicensed personnel may be absent. An intra-hospital transport checklist was developed for non-critical care patients leaving the unit for procedures in the imaging department.

Do:

• A "RN Pre-Invasive Procedure Transport Safety Checklist" was created by a telemetry RN (MSN student, Greta Titus) and CNS, Teresa Jahn
• The checklist was designed to answer questions …

Transitions To Normal Saline Only For Cvads, Megan Lehn, Ann Backes

Nursing Posters

Purpose Statement:

The purpose of this project is to implement a practice change throughout the system to remove heparin flushes for Central Venous Access Devices (CVADS) pending a successful pilot on Medical Oncology.

Synthesis of Evidence:

• Shama et al (2019) conducted a systematic review and meta-analysis including 886 participants that revealed no clear differences in CVC patency between heparin and NS.
• Klein et al (2018) conducted a pilot study on a 30-patient bone marrow transplant unit, each patient had a new CVC and were divided into two groups. Among 698 catheter-associated events overall incidence of central line issues were similar …

Rural Maternal Care Crisis & Strained Workforce: An Integrative Review Revealing Factors In The Rural Maternal Care Crisis, Taylor F. High Elk

All Electronic Theses and Dissertations

Introduction: The United States is comprised of 75% rural areas and settings (American College of Obstetricians and Gynecologists (2014). Nearly five million women in the US do not have access to maternity care in the county in which they reside (Uribe-Leitz et al., 2022). Purpose: The purpose of this integrative review is to assess the hospitals that provide maternity care in rural settings, the procedures performed in these locations, and the maternal care workforce in the rural obstetric setting. The goal of this research is to identify why there is a lack of maternity care in the rural setting, and …

1 Parents Experiences In Slovenia During The Covid-19 Pandemic, Petra Klanjsek, Leona Cilar Budler, Jadranka Stricevic, Tara L. Sacco, Barbara Kegl

Nursing Faculty/Staff Publications

Introduction: The COVID-19 pandemic emerged here in March 2020. The pandemic and lockdowns have been the cause of many parents doing both paid and unpaid work at home. Everyday life was a great challenge. Challenges, insecurities, and changes have caused people anxiety and fear, which has been and will only be reflected in the mental well-being of individuals. We wanted to find out how parents faced their fears, worries, and daily lives during the epidemic.

Methods: A cross-sectional study was conducted to gain insight into parents’ experiences during the COVID-19 pandemic in Slovenia. Casual parental sampling was used and a …

Pmh Connect, English (Greyscale For Printing), Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, EspañOl_Full Color, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …

Pmh Connect, EspañOl_Greyscale For Printing, Sara W. Moyer, Patricia Kinser

School of Nursing Publications

Mental health related symptoms and associated experiences in the perinatal period present challenges, particularly regarding identification and appropriate management. Perinatal Mental Health (PMH) screening occurs in clinical settings on a more regular basis than ever before thanks to validated screening measures used at perinatal visits; however, pregnant and parenting individuals report several concerns when completing these screeners and providers report barriers in addressing resultant findings. To address barriers and enhance the PMH screening experience, this team of clinicians and researchers propose a tool – the PMH Connect: a Perinatal Mental Health Screening Connection, Education, and Decision Aid – to be …