Nursing Commons^™

How Covid-19 Changed New Nurse Orientation, Lindsey Js Sanders

MSN Capstone Projects

Universities were no longer able to do in person learning for nursing students. Nursing students were being taught vital skills like inserting an IV catheter via online simulation. The number of hours nursing students had to participate in clinical hours at the hospital was diminished due to the hospitals not allowing in nursing students. This created a huge educational deficit in nursing students. The nursing students who graduated during the COVID-19 pandemic are arguably less skilled than their predecessors before them. To fill this educational gap, additional training and orientation time must be provided to allow for fully competent new …

Palliative Care Services On An Adult Inpatient Oncology Unit, Heather E. Barger

Dissertations

Abstract

Problem: Palliative care (PC) services are widely underutilized for patients with cancer, partly due to the shortage of PC specialists. Additionally, many Americans have not filled out advance directive (AD) paperwork which is commonly addressed in PC. In the absence of an AD, cancer patients are at risk of receiving undesired aggressive treatments in the event they are unable to make decisions independently.

Methods: This quality improvement pilot initiative utilized a descriptive observational design to evaluate the number of ADs documented in the electronic health record (EHR) on an inpatient oncology unit. A retrospective EHR review was used to …

The Overlooked Care Plan- Nursing Mindset Related To Self-Care: An Integrative Review, Marie Mulford

Doctoral Dissertations and Projects

COVID-19 brought to light many things worldwide. One of the pressing issues was the increased rates of burnout, depression, and suicidal risk among nurses. This called for examining nurses’ work experiences and overall well-being during the Coronavirus pandemic. Furthermore, it was revealed that the nursing mindset regarding self-care was overlooked. This integrative review will inform stakeholders about the “overlooked care plan.” This review will be a call to action built on existing knowledge and facilitate policy for the nursing profession. Building upon nursing science, informative research, and facilitating policy initiatives, this review will serve as a call to action for …

Use Of Text Messaging For Type Two Diabetes Management In Patients Over Sixty-Five, Charles Head

Master of Science in Nursing Family Nurse Practitioner

Why is there a need for tight glucose control for diabetics sixty-five years old or older? Tight control of glucose which can be trended as a 90-day snapshot of blood sugar control is measured using HgA1C levels(Centers for Disease Control and Prevention, 2019). HgA1c levels under six percent in diabetics have been shown to reduce diabetic complications that be detrimental to health(Krapek et al., 2004). Adults aged sixty-five years old or older are also at greater risk for the development of acute and chronic diseases that are a result of poor blood sugar management(Leung et al., 2018). Adherence to prescribed …

Nursing Instructors Preparing Nursing Students To Cope With Distractions When Administering Medications: A Phenomenological Qualitative Study, Michael Thurman Frazier

Doctoral Dissertations and Projects

The purpose of this hermeneutic qualitative study was to discover and describe how nursing instructors teach nursing students to cope with interruptions and distractions while administering medication. The hermeneutic phenomenology approach is appropriate for discovering what nursing instructors teach their students about distraction in the classroom, simulation laboratory, and clinical setting. The study’s guiding theory was Kolb’s experiential learning theory. Nursing instructors from associate and bachelor’s degree programs from across the United States were recruited to participate in this study. The participants completed questionnaires about medication administration instruction, expanding on their answers in semi-structured, one-on-one interviews. All participants had the …

Health Services Survey, Doan (Delaney) Le, Hannah Gries, Cassandra Roy, Lesley Rabago, Franzelle Macaspac

Nursing Leadership in Community Engagement Projects

Health Services Survey

The agency we partnered with is a nonprofit organization committed to serving the needs of women and their families who are experiencing unstable or absent housing. They help to provide emergency shelter to families across five locations in the Seattle area and provide services surrounding housing, healthcare, employment, and community. They also have specialty programs aimed at providing services to children who are medically fragile and require specialized care, and families who have recently given birth and are still in the recovery and bonding stages. All this work is delivered with the values of love, equity, stewardship, …

Effect Of Dedicated Admission Medication Reconciliation On Patient Care In 100-Bed Acute Care Hospital, Judy Mcmanus

Student Scholarly Projects

Practice Problem: Medication reconciliations are often completed inadequately or inaccurately when patients are admitted to the hospital. Findings at the study site identified an average of two pharmacy interventions necessary per admitted patient to correct home medication lists after completion of the medication reconciliation.

PICOT: The PICOT question that guided this project was “In adult patients admitted to a 100-bed acute care hospital (P), how does use of the MATCH toolkit for medication reconciliation process steps (I), compared to the current process of home medication reconciliation completed by the physician prior to nursing or pharmacy team review (C) affect accuracy …

Food Resources For The Allen Family Center, Anna Kolbjornsrud, Jagrup Kaur, Simran Kaur, Talyn Miller, Chloe Schrader

Nursing Leadership in Community Engagement Projects

Food Resources for the Allen Family Center

Allen Family Center (AFC), a part of the nonprofit organization Mary’s Place, is a family driven resource hub that focuses on the needs and goals of families experiencing or on the verge of homelessness (Mercy Housing, 2022). They use a multigenerational approach to break the cycle of homelessness which promotes inclusivity, safety and provides opportunities to improve health (Mercy Housing, 2022).

When meeting with the team, we identified a concern as the limited food supplies available to AFC and the lack of food outreach they can provide. Providing resources to the community is …

Pick Your Plate: A Nutrition Education Study, Emmalyn Tucker

Honors College Theses

Childhood obesity has become a cause for concern among many nutrition experts. Childhood obesity can contribute to several health problems such as type 2 diabetes, asthma, high blood pressure. The large percentage of children affected with childhood obesity suggests a lack of essential nutrition education in our country. Junk food consumption and inadequate intake of the USDA’s MyPlate food groups have become essential areas for intervention. Multiple school-based nutrition education interventions have been explored to improve both children’s nutrition knowledge and improve healthy eating behaviors. “Pick Your Plate” is a nutrition education study designed to improve nutrition knowledge regarding junk …

Nurse-Initiated Treatment Reduces Costs For Acute Asthma In A Pediatric Emergency Department, Michael D. Johnson Md, Ms, Minkyoung Yoo Phd, Richard E. Nelson Phd, Amanda K. Nielson Md, Lauren Allen Mas, Nanette Dudley Md, Brandon Andersen Rrt, Amanda Orme Dnp, Cpnp-Ac, Cameron Mcfarland Np-C, Michael Mundorff Mba, Mhsa

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Standardized emergency department (ED) pathways can improve care delivery to children with acute asthma, though their impact on hospitalization and costs is unclear. An Acute Asthma Care Pathway (AACP) that facilitates nurse initiation of treatment was implemented at a tertiary care pediatric ED using standard quality improvement methodology. The impact of implementation was assessed using process control methodology and multivariable time series analyses between pre- and post-implementation periods. Provision of a steroid within 30 minutes and 60 minutes of arrival increased by 21 and 22 percentage points respectively, IV magnesium sulfate administration increased by 30 percentage points, the proportion hospitalized …

Outcomes Of Asthma Quality Improvement In Pediatric Patients, Kathryn M. Murray Md, Faap

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Introduction. The Utah Pediatric Partnership to Improve Healthcare Quality (UPIQ) and Utah Department of Health (UDOH) Asthma Program Learning Collaborative is a quality improvement initiative designed to standardize asthma care in pediatric patients and improve the overall assessment and patient education process for both healthcare providers and patients. The aim of the Asthma QI Project was to improve the diagnosis and management of asthma for patients in the state of Utah by implementing a standardized approach to the identification and treatment of patients with asthma.

Methods. Patients scheduled to see a healthcare provider at our pediatric clinic were screened for …

Addressing Culturally Congruent Care Amongst African Americans In Skilled Nursing Facility: A Systematic Review, Adekemi T. Adedipe

DNP Qualifying Manuscripts

Introduction: Healthcare disparities and mistrust of the healthcare system discourage African Americans from seeking mental health services. Healthcare providers face challenges delivering culturally appropriate care. Examining current cultural practices can inform the education needed for healthcare providers to understand cultural care and awareness. This review aimed to identify evidence available to understand the impact of a cultural training on healthcare providers in skilled nursing facilities.

Methods: APA PsycINFO, CINAHL, and PubMed, were searched for English-language studies published between January 2016 and January 2022. Healthcare cultural competency training

in any aspect of cultural care was considered. Outcomes of interest included changes …

Screening For Social Determinants Of Health To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

From The Other Side: Nurses’ Perception On The Use Of Negative Pressure Wound Therapy In Clinical Setting, Chinal Patel

Honors College Theses

Negative Pressure Wound Therapy (NPWT) is a revolutionary technology being used more frequently in clinical settings across the United States. Though there has been extensive research on the efficacy of NPWT medically and otherwise, there has been little research regarding the healthcare providers’ perception of use of “wound-vacs,” the device used for NPWT. As new techniques and/or devices are made available for use in a clinical setting, the burden to educate staff falls upon patient care providers. The administration of NPWT is wholly reliant on a nurse as they are the ones to apply the dressing, change it and document …

Transient Ischemic Attack And Admission To A Dedicated Unit, Bandi Davini

Student Scholarly Projects

Transient ischemic attacks account for admissions of approximately 70% of patients who present to the emergency department with transient vascular symptoms, with an average length of stay of one to seven days, costing, on average, $22,087 (Qureshi et al., 2013). A hospital organization's bed efficiency directly affects quality metrics. Reducing the length of stay in TIA patients by having them admitted to a dedicated unit with whom the staff has experience managing stroke patients and the understanding of specific criteria needing to be met before discharge can directly impact quality metrics and provide cost-effective delivery of care. The PICOT question …

A Clinical Dashboard To Reduce Missed Opportunities To Measure Dialysis Adequacy, Kassandra J. Goodman, Cora L. Wilson, Ann R. Loth

Nursing DNP Projects

In the local department, pre-pilot dialysis adequacy data was housed in a spreadsheet with manually entered, month-old data, inaccessible to clinic staff. The inoperability of the local QAPI workbook and EHR as well as data inaccessibility to staff resulted in missed opportunities to measure Kt/V. Based on the synthesis of evidence, dashboards have been utilized in a variety of interdisciplinary clinical settings with positive outcomes in addressing patient care gaps. The purpose of this pilot was to implement the Epic Dashboard that displays automated, real-time quality metric data to reduce missed opportunities to measure Kt/V in the outpatient HD setting. …

Fall Prevention Among Older Adult Behavioral Health Patients, Jodie Shipley

Dissertations

Abstract

Problem: Inpatient falls are a major patient safety issue. Behavioral health units experience higher rates of falls among elderly patients with between 13.1 to 25 falls per 1,000 occupied bed days (OBD). The risk of falls for the aged population is increased on a psychiatric unit due to a myriad of issues including psychotropic medications, over-activity on the unit, and confusion (Wong & Pang, 2019).

Methods: This QI project is an observational descriptive pilot intervention evaluation of a redesigned fall prevention program with the aim to reduce falls on a midsized suburban Midwestern inpatient geriatric behavior health …

Resilience And Prenatal Mental Health In Pakistan: A Qualitative Inquiry, Shireen Shehzad, David Arthur, An-Sofie Van Parys, Nicole Letourneau, Gail Wagnild, Shahirose Sadrudin Premji, Nargis Asad, Olivier Degomme

School of Nursing & Midwifery

Background: Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.
Methods: The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A …

Infection Control: Proper Handwashing Technique Within A Vulnerable Population, Seattle Pacific University

Nursing Leadership in Community Engagement Projects

Introduction

Recovery Café is a place of healing and recovery for those experiencing a variety of different kinds of traumas and experiences, whether it be homelessness, substance abuse, domestic violence, and others. This alcohol and drug free space is provided for members so that they can build relationships amongst each other, and gain access to resources such as housing, employment, support circles, social and health services. Typically open from 12-6, this community provides two free meals a day, resources, and ongoing support for their members regardless of past trauma, behaviors, and mistakes. Since the largest population group in this community, …

Functional Links Between Thermoregulation And Sleep In Children With Neurodevelopmental And Chronic Health Conditions, Susan M. Mccabe, Chris R. Abbiss, Jean Pierre Libert, Véronique Bach

Research outputs 2022 to 2026

The bi-directional relationship between sleep and wake is recognized as important for all children. It is particularly consequential for children who have neurodevelopmental disorders (NDDs) or health conditions which challenge their sleep and biological rhythms, and their ability to maintain rhythms of participation in everyday activities. There are many studies which report the diverse reasons for disruption to sleep in these populations. Predominantly, there is focus on respiratory, pharmaceutical, and behavioral approaches to management. There is, however, little exploration and explanation of the important effects of body thermoregulation on children’s sleep-wake patterns, and associated behaviors. Circadian patterns of sleep-wake are …

Smoking Addiction In Patients With Schizophrenia Spectrum Disorders And Its Perception And Intervention In Healthcare Personnel Assigned To Psycho-Rehabilitation Programs: A Qualitative Research, Pasquale Caponnetto, Marilena Maglia, Marta Mangione, Chiara Vergopia, Graziella Chiara Prezzavento, Riccardo Polosa, Maria Catena Quattropani, Jennifer Dipiazza, Maria Salvina Signorelli

Publications and Research

Patients with schizophrenia spectrum disorders have a higher prevalence and frequency of smoking rates when compared to the rest of the population; to this, it must be added that they develop a greater dependence and have some worse health consequences than the general population. This is qualitative research on the perception of smoking in healthcare professionals assigned to psycho-rehabilitation programs for patients with schizophrenia spectrum disorders. The point of view of health personnel (Psychologists, Psychiatrists, Pedagogists, and Nurses) about cigarette smoking in these patients was analyzed, focusing on their implications in disturbance and comparing them with e-cigarettes too. The methodology …

Reducing Central Venous Infections, Desiree Banton

Student Scholarly Projects

Practice Problem: Patients in the hospital are 36.6% more likely to die after a diagnosis of a Central Line-Associated Bloodstream Infection (CLABSI) (Chovanec et al., 2021). The purpose of this evidence-based practice implementation is to reduce CLABSI rates in the Neurological ICU (Neuro ICU) at a private medical center through use of a CLABSI prevention bundle checklist each shift.

PICOT: In the adult neuro-ICU (P), how does implementing a CLABSI prevention bundle checklist each shift (I), compared to current practice (C), affect CLABSI rates (O) within eight weeks (T)?

Evidence: Evidence-based research supports that if clinical staff completed each part …

Early And Progressive Mobility: A Program Implementation Strategy For High Acuity Patient Care Locations, Stefani Poland

Student Scholarly Projects

Despite an increase in the promotion of early progressive mobility, its decrease in hospital-acquired complications and improvement of patient outcomes, there remains a reluctance in staff commitment to daily evaluation and implementation. This is largely due to the fact nurses or other interprofessional staff are the primary individuals responsible for this change in process. A lack of confidence in staff to correctly identify patients that meet criteria and anxiety regarding the safe transfer or mobilization of patients, particularly in high acuity settings have been identified as major barriers. The PICOT question that guided this program development of a CBO toolkit …

Preventing And Reducing Nurse Burnout In An Outpatient Military Facility, Lisa Haik

Student Scholarly Projects

Practice Problem: Nurse burnout adversely affects nurses, patients, and healthcare organizations. Implementing changes to address key contributors to burnout can effectively reduce and prevent burnout.

PICOT: The PICOT question that guided this project was: In outpatient clinic nurses (P), how does implementing a bundled strategy (I) compared to not providing interventions (C) affect nurse burnout (O) within eight weeks (T)?

Evidence: Evidence from an extensive literature review showed that there is no single cause for burnout and therefore no single intervention to reduce or prevent it. The primary themes in the literature to address burnout include practicing mindfulness, …

Team Engagement & Obstetrics Transformation Committee, Colette Dumais, Faye Weir, Lynn Willey, Kristen Heanssler, Brittany Babb, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Obstetrics Transformation Committee,Maine Medical Center

Operations Transformation

Gallup defines employee engagement as the involvement and enthusiasm of employees in their work and workplace. Employee engagement helps to measure and manage employees' perspectives on the crucial elements of workplace culture. Based on over 50 years of employee engagement research, engagement employees produce better outcomes (better patient care) than other employees. Based on the unit survey, team members, with the support of local leaders, formed the Transformation Committee. This Committee was developed as a shared governance, team led model to address process improvement needs and create a culture of active engagement in problem solving.

Postoperative Vital Signs: Traditional Versus Evidence Based, Linda Otis Bsn, Rn

Nursing Publications, Posters, & Presentations

Poster Presented at the Nursing Research Symposium 2022.

Problem: Post operative vital signs Did not guide the nurse to identify postoperative complications. Purpose: The purpose of the study is to compare the current standard post-operative nursing vital signs and assessment routine to an evidence based algorithm(TRAX) drive routine. The Trax algorithm is initiated by nursing assessments which then determine the frequency and tye of postoperative vital signs

No Evidence Support For Intake/Output Documentation, Kristen Schultis Bsn, Rn

Nursing Publications, Posters, & Presentations

Poster Presented at the Nursing Research Symposium 2022.

Objective: Upon the change of Dekalb hospital as a Parkview hospital, adoption of policies and standards were in process. • The standard of care for intake/output (I/O) documentation was found to be every 8 hours at defined time periods of 6am, 2pm and 10pm in the hospital setting. • The reality of nursing practice with electronic documentation facilitates ‘real-time’ documentation of I/O, so the question was raised as to why should we wait until 6a, 2pm, and 10pm do document I/O?

The purpose of this project was to determine best practice for …

Closing The Experience Complexity Gap Using Peripheral Iv Education, Taylor N. Daughtery Msn, Rn, Cv-Bc, Cphq, Melinda M. Webb Bsn, Rn, Va-Bc, Stephani Schultz Bsn, Rn, Cmsrn

Nursing Publications, Posters, & Presentations

Poster Presented at the Nursing Research Symposium, 2022

Introduction

At Parkview Health System, a gap in peripheral IV (PIV) insertion education was identified. • PIV insertion is not a curriculum priority in nursing school. • In practice, IV insertion needs to be completed in a timely manner to avoid care delays. • An aversion to starting PIVs, by new and seasoned nurses, create unique barriers to PIV insertion. • Experienced nurses may not be well versed in placing IVs due to the availability of a hospital IV team. To close the experience complexity gap and incorporate all learning styles, the …

Weighted Blanket Versus Traditional Perioperative Practices On Anxiety And Pain In Elective Surgery Patients: A Randomized Controlled Trial, Danielle Payne , Msn, Bsbio, Rn, Jaime Vinson Bsn, Rn, Hn-Bc, Jan Powers Phd, Rn, Ccrn, Brandon T. Mcdaniel Phd, Cherise Sevier, Cynthia Marshall, Sue Sell

Nursing Publications, Posters, & Presentations

Poster presented at Nursing Research Symposium 2022.

Introduction: Perioperative anxiety is common in surgical patients and has been linked to poor patient outcomes. A weighted blanket may offer an alternative to or enhancement of anti-anxiety medications by activating a physiological response through the vagal system. This response successfully decreases anxiety and agitation in other patient populations but had not been studied in this population. This randomized study assessed the effectiveness of a weighted blanket for the reduction of presurgical anxiety and pain as well as post-surgical restlessness and nausea.

Depression Awareness Programs For Adolescents: A Scoping Review, Kincharska N. Freeman Msn, Aprn, Fnp-C, Cnor, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

The purpose of this DNP project is to determine if receiving school-based depression awareness education affects the depression scores of adolescents between 10 and 19 years of age.