Nursing Commons^™

Education Interventions And Preeclampsia Knowledge Among Pregnant Women, Shantel Mir

Honors Undergraduate Theses

Aim: The aim of this literature review was to explore the impacts of educational interventions integrated into antenatal care on knowledge of preeclampsia among pregnant women. Background: Preeclampsia has remained one of the leading causes of preventable maternal and infant mortality and morbidity. A lack of patient education and awareness of preeclampsia may lead to missed opportunities for diagnosis and preeclampsia complications. Methods: CINAHL Plus with Full Text, MEDLINE, and Education Full Text (H.W. Wilson) databases were utilized. Literature specifically focusing on preeclampsia educational interventions among pregnant women were considered. Results: There were eleven articles that fit the criteria …

The Psychological Impact Of An Intensive Care Admission On Survivors Of Acute Respiratory Distress Syndrome And Covid-19 Ards, Leah K. Shinn

Honors Undergraduate Theses

Background:

With the COVID-19 pandemic, there has been an influx of patients with acute respiratory distress syndrome (ARDS), an inflammatory lung condition. ARDS survivors are at high risk for developing post-traumatic stress disorder (PTSD) due to intensive care unit (ICU) medical treatments/procedures. They are known to have traumatic memories triggered by their sensorium months to years after being discharged from the ICU. One study found that 23% of ARDS survivors experienced long-term PTSD symptoms 2-3 years after hospital discharge (Bienvenu et al., 2018). Unknown is whether there are similarities in the memories and sensory triggers of PTSD amongst ARDS and …

The Effects Of Diet And Lifestyle On Wound Healing, Chinwe Orabuchi

Doctor of Nursing Practice Projects

A current policy for wound care and teaching is present at Reskin Clinic. However, nurse practitioners identified delays in wound healing. A retrospective review of approximately 50 patient charts compared wound healing of patients who have stated they adhere to a healthy diet and lifestyle compared to those who do not. This information was compared to the patient's chart and determined what type of education on wound care, diet, and lifestyle changes were documented in the patient chart. Inclusion criteria includes patients ages 50+ with acute or chronic wounds. The results of this retrospective review demonstrated a lack of nutritional …

Review Of The Literature On Reducing Aggressive Behavior In Patients With Acquired Brain Injury Intervention, Krystal Weber

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Patients with brain injuries are often impulsive and experience increased aggression and agitation. Increased behaviors lead to an increase in violent outbursts towards healthcare staff. Implementing an order outlining interventions to reduce agitation in brain injury patients may reduce behavioral emergencies.
/="/">Methods: Staff working in orthopedic/neurology, critical care, and rehabilitation inpatient units were educated on preventing agitation in brain injury patients and an order was placed in the patients' charts with guidelines on preventing agitation. The guidelines were implemented for all patients meeting inclusion criteria and the number of behavioral emergencies before and after intervention were compared. Results: …

A Comparison Of Outcomes For Lipid Emulsions In Total Parenteral Nutrition Among Home Infusion Patients, Gregory W. Wesley-Lynch

DNP Scholarly Projects

This quality improvement project aimed to compare the outcomes of lipid emulsions used in total parenteral nutrition among home infusion patients. The quality improvement project included 45 patients who received four weeks or more of either Intralipid or SMOFlipid. Paired t-tests were used to compare SMOFlipid and Intralipid regarding three liver function test (LFTs) values; (Alkaline Phosphate (ALP), Aspartate transaminase (AST,) and Alanine transaminase (ALT). Results demonstrated that SMOFlipid was superior to Intralipid, resulting in lower LFTs for ALP, AST, and ALT. This study provides evidence to support the use of SMOFlipid over Intralipid in total parenteral nutrition for home …

Implementation Of A Standardized Process To Increase Promotion Of Family Presence During Resuscitation, Eileen Hollis

DNP Scholarly Projects

BACKGROUND: Family Presence During Resuscitation (FPDR), has been studied and recommended as an important and relevant practice for decades, yet it remains controversial with frequent barriers to implementation. The benefits of this practice are numerous; and to truly embrace shared decision making, nurses and providers must encourage patients and families to participate in all aspects of care, even during resuscitation events. As evidence supporting the emotional and psychological benefits of FPDR began to grow, however, a global pandemic brought family presence to an abrupt halt.

METHODS: This quality improvement project’s focus was to standardize a process for offering and allowing …

Utilizing Outpatient Telehealth As A Treatment Approach For Patients With Substance Use Disorder: A Quality Improvement Project, Veronica Kwegyir-Afful

DNP Scholarly Projects

Background: The issue of substance use disorder (SUD) has demonstrated a growing prevalence both in the United States (U.S.) and globally. Effective treatment modalities have been devised for individuals afflicted by SUD, thereby enabling their post-treatment prognosis to be parallel to that of patients with other chronic diseases, such as diabetes. However, several factors or barriers impede individuals with SUD from assessing treatment. These barriers encompass financial constraints stemming from inadequate insurance coverage and high cost, the stigma surrounding SUD, which results in patient's hesitancy to seek treatment treat, adverse societal attitudes, collateral social percussions like work hour losses and …

Implementation Of Virtual Reality For The Laboring Patient: A Quality Improvement Project, Chantal Cole

DNP Scholarly Projects

BACKGROUND: Having a baby can be one of the most challenging and painful experiences a woman has in their lifetime. Being able to choose between a variety of pharmacological and non-pharmacological pain-control methods is important to improve the patient experience and outcomes. This quality improvement project aimed to introduce a virtual reality device into the labor and delivery setting as a non-pharmacological pain control method. The goal was to decrease pain and anxiety levels, decrease the rate of epidural anesthesia use, and decrease the length of time epidural anesthesia medication was running before delivery.

METHODS: The four key components of …

Strengthening New Hampshire’S Primary Care Workforce Pipeline: Utilization Of Alternative Scheduling Models, Elizabeth Harrison

DNP Scholarly Projects

Abstract

BACKGROUND: Traditional clinical scheduling coupled with the current reimbursement system have created systematic barriers leading to decreased clinical education opportunities. Alternative scheduling models such as longitudinal integrated clerkships, one preceptor to two students and wave scheduling have the potential to eliminate these barriers and provide financial gains and increased access to care.

INTERVENTION: Interventions to meet this quality improvement project's objectives included (1) pre-intervention planning (2) focus groups, (3) video presentations and (4) a pilot program of alternative scheduling models in clinical practice.

RESULTS: A pilot program utilizing the alternative scheduling models increased the relative value units (RVU) of …

A Quality Improvement Initiative: Addressing Workplace Violence Toward Nurses To Promote A Culture Of Safety In An Inpatient Psychiatric Facility, Ernestina Danso

DNP Scholarly Projects

This quality improvement initiative aimed to address workplace violence against nurses in inpatient psychiatric facilities and promote a culture of safety. The QI project involved 27 participants, including inpatient psychiatric nurses and mental health counselors from Cahill 4 and 7 West units at the Cambridge Campus. The primary objective was to identify challenges that hindered the effective utilization of the Broset Violence Checklist (BVC) tool for referring patients to sensory modulation rooms.

Pre- and post-intervention surveys were conducted to assess participants' self-reported knowledge and barriers to BVC and sensory room utilization. Educational sessions covering workplace violence, debriefing techniques, and the …

A Quality Improvement Initiative To Improve Access And Patient Flow In A Non-Emergency Walk-In Care Clinic, Renee J. Broze

DNP Scholarly Projects

Background: A community-based non-emergency walk-in clinic in Southern New Hampshire experienced high volume and inefficient workflows during the pandemic, causing delays in care, long visit times, and low net promoter scores.

Purpose: Institute an evidence-based approach to improve work efficiency through innovative models of care.

Methods: A literature review on best practices for workflow redesign guided the project. The project instituted an on-demand telemedicine service and a clinic fast-track workflow. A mixed methods approach analyzed pre /post cycle times, net promoter scores, and themes from staff interviews. Pre/post cycle times analyzed 12,767 completed appointments.

Results: There was a statistically significant …

Exploring & Mitigating Workplace Incivility At A Rural Community Hospital, Jacquelyn Ethier

DNP Scholarly Projects

Workplace Incivility (WI) is a well-known challenge in healthcare, with decades of mounting evidence showing the effects on workplace culture, healthcare worker retention and patient safety. The nursing workforce has become increasingly vulnerable to all stressful elements of the work environment. Organizational leadership must develop and deploy mitigation strategies to minimize the negative consequences of these behaviors for nurses, and the entire healthcare team. The purpose of this quality improvement project is to assess the current state of nurse perceptions of WI at a rural community hospital and deploy evidence-based education on strategies to address and mitigate WI. The method …

Facilitating Palliative Care In A Critical Access Hospital System: Implementation Of Screening And Educational Interventions, Michele Lovell

DNP Scholarly Projects

BACKGROUND: The United States health care system faces the dual challenge of an aging population with a concomitant increase in the presence of chronic and serious illness, the care of which accounts for the nation’s largest expenditure of burgeoning healthcare costs. Palliative care is specialized care for people with serious illness aimed at reducing suffering, optimizing quality of life, and enhancing medical decision making. An ample evidence base demonstrates that palliative care increases both quality of care and patient and family satisfaction while also reducing associated costs. The aim of this quality improvement project was to facilitate palliative care services …

Improving Patient Safety And Emergency Department Staff Efficiency In Barcode Medication Administration By Using The Rover™ Mobile Application, Ian Kirit

DNP Scholarly Projects

BACKGROUND: The Emergency Department (ED) is one of the busiest areas in the hospital. Patients are often acute, and it can get chaotic at times. Such a complex environment requires an effective and efficient system to increase staff efficiency and elevate patient safety. Patient and medication scanning has been a continuing issue with the current barcoding process using the in-room scanners and workstations on wheels (WOWs). In reviewing the Barcode Medication Administration (BCMA) weekly audit report, scanner broken and scanner not available are the most frequently used reasons for not scanning patients and medications. Additionally, WOWs can be hard to …

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

Comparison Of Cultural Self-Efficacy Between Urban And Rural Nurse Educators, Denise Rene Morris

Walden Dissertations and Doctoral Studies

Integration of an inclusive educational environment requires nursing faculty to embrace a transformational change in academics. The cultural interactions of an educator teaching in an urban district may differ from the relations experienced by a rural nurse educator. The purpose of this quantitative study, guided by Bandura’s social cognitive theory, was to determine whether there is a difference between the cultural self-efficacy scores of nurse faculty teaching in a rural location compared to those in an urban location as well as whether the demographics of age, ethnic background, and years in the nursing profession predict cultural self-efficacy scores. Nursing faculty …

Improving Veteran’S Care Outcomes With The Implementation Of Care Coordination, Katrina Ann Canady

Walden Dissertations and Doctoral Studies

AbstractAstute care coordination is essential to eliminating fragmented care, duplication of services, medication errors, and unnecessary emergency rooms visits. This Doctor of Nursing practice project was a quality improvement (QI) initiative that addressed the gap in practice regarding RN care managers who were not consistently performing care coordination as outlined by the office of community care at the project site. The purpose of the project was to evaluate the effectiveness that an educational intervention had on the RN care managers’ abilities to perform care coordination. The care coordination model (CCM) served as the project framework because it provides a systematic …

Improving Advanced Practice Registered Nursing Knowledge Of Shingles Management, Kyla Gilbert

Walden Dissertations and Doctoral Studies

AbstractShingles is a viral infection that can adversely impact patients if not promptly treated. In the project facility, a gap in practice was identified when a 6-month facility chart review noted a delay in shingles diagnosis 60% of the time. It is important for the Advanced Practice Registered Nursing (APRN) to be knowledgeable regarding diagnoses and best practices for treatment of shingles. However, the local facility had no available education on shingles. The practice-focused question asked whether APRN knowledge of shingles could be improved through staff education. The doctoral project provided shingles education to address the identified knowledge gap. The …

Fall Prevention On The In-Patient Neurological Stroke Unit, Syvol Letwan Middleton

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quality improvement (QI) evaluation project was to decrease patient falls on a neurological stroke unit. This unit had the most falls throughout the hospital system. The unit averaged 50-60 falls per year with an average of 4.75 falls per month. Guided by Neumann’s system model, the project targeted those patients at the highest risk for falling related to deficits post-stroke and post-neurological disease process. Staff were informed about Last fall, Express needs, Awareness of safety, and Frequency of bowel and bladder (LEAF) to determine if this tool could decrease falls in the neurological stroke population patients. …

Nurses’ Experiences With Trauma-Informed Care In Patients With Psychological Trauma, Ade J. Vinton

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic increased the need for research and discussions about trauma, trauma-informed care (TIC), and care delivery processes. Little is known about how nurses recognize, assess, treat, and support patients who experience trauma although knowledge of TIC is important for delivering care to trauma survivors. The purpose of this qualitative descriptive study was to explore nurses’ perceptions of TIC principles and their experiences delivering care to patients with psychological trauma. Harris and Fallot’s TIC theory was used to guide the study. Purposeful sampling was used to recruit ten nurses for individual semi structured interviews using open-ended questions conducted via …

Educating Nurses On Mental Fatigue, Tawanna Ann Canty

Walden Dissertations and Doctoral Studies

Education correlates with nurse performance and avoiding mental fatigue. This project attempted to answer the question, “Educating nurses on mental fatigue will increase knowledge” focusing on educating rehabilitative nurses regarding mental fatigue. The project was guided by the Analysis, Design, Develop, Implement, and Evaluate model. Twenty rehabilitative nurses were administered a pretest consisting of 10 multiple-choice test questions. They received education on mental fatigue through PowerPoint presentations and handouts. After completing the education, participants were administered a posttest with the same 10 questions. An evaluation tool consisting of six questions was completed measuring an increase in knowledge after the posttest. …

Education Program To Increase Nurses' Knowledge Of Faith Community Nursing, Lovell Thurmon Sweeten Cartwright

Walden Dissertations and Doctoral Studies

AbstractThe practice problem was a group of nurses practicing as faith community nurses (FCNs) who had no training in FCN practice, a specialty recognized by the American Nurses Association. This problem was important to address within the context of nursing practice because the nurses could have acted outside of their scope of practice and caused harm. The practice-focused question addressed whether a staff education program for FCNs would increase their knowledge of their role in a church setting with the goal of developing independent FCNs. The model guiding the project was the health promotion model. Eleven registered nurses were recruited …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Staff Education To Promote Probiotic Breastfeeding Therapy, José Diaz

Walden Dissertations and Doctoral Studies

Preterm birth is the leading cause of death in children under 5. In addition, there are 22 million babies born underweight each year which also contributes to the infant mortality rate. Some reasons for the inability to thrive and survive are the infants' immature system, allostatic load inadaptability, and undiversified and underdeveloped microbiota. Human breast milk (HBM) provides lifesaving nutrients, which prevents necrotizing enterocolitis and mortality. In addition, probiotic supplementation helps reduce late-onset sepsis, morbidities, and mortality. A literature review provided substantial evidence that HBM and probiotics can improve an infant's microbiota, thus improving thrivability and survivability. Probiotics offset the …

Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney

Walden Dissertations and Doctoral Studies

Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …

Adverse Childhood Experiences, Nicotine Dependence, And Depressive Symptoms Among A Community Sample Of People With Mental Illnesses, Bassema Abufarsakh

Theses and Dissertations--Nursing

Adverse childhood experiences (ACEs) pose a major public health issue as they are associated with poor mental and physical health outcomes. In the United States (US), more than 60% of adults report at least one ACE, and around 15% experienced four or more. Repeated exposure to ACEs stressors can convert ACEs to toxic stress by altering the brain's architecture and function. Evidence suggests that exposure to four or more ACEs, which are indicators of exposure to toxic stressors, is associated with nicotine dependence (ND) and depressive symptoms. Moreover, people with mental illnesses (MI) often have greater exposure to toxic stressors …

Alternative Pharmacology: Exploring Ketamine Use For Treatment Resistant Mental Health Disorders, Kiersten L. Ash

Soaring: A Journal of Undergraduate Research

No abstract provided.

Use Of A Nurse-Led Daily Goals Checklist To Improve Multidisciplinary Rounds In The Icu, Marissa Riley

DNP Projects

Research has shown a multidisciplinary rounding approach can improve patient care outcomes in the intensive care unit (ICU). Due to the complexity and wide range of the healthcare team, many patient details and treatment goals may be overlooked during daily patient rounds without a daily goals checklist to help ensure collaboration and communication of the multidisciplinary team. A nurse led daily goals checklist could be useful for framing nurse-provider conversations to promote comprehensive communication and collaboration. The purpose of this project was to improve adherence to a nurse-led daily goals checklist to improve communication and collaboration between the nurses and …