Nursing Administration Commons^™

Pots: Educating School Nurses, Stephanie Sherwood

Doctoral Dissertations and Scholarly Projects

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident …

Programs That Can Support Nurses To Reduce Compassion Fatigue And Secondary Traumatic Stress: An Integrative Literature Review, Molly Gruettner

Grace Peterson Nursing Research Colloquium

Compassion allows a nurse to empathize with their patient and their family, but it does not prepare the nurse to cope with stressful events. Repeatedly being exposed to traumatizing events, pain, distress, and suffering can lead to nurse burn-out and fatigue. Compassion fatigue is a unique form of burnout and secondary traumatic stress (STS) encompasses ideas of compassion fatigue and the two terms are often used interchangeably. Objective: The goal of this systematic integrated literature review is to discover interventions to reduce compassion fatigue and STS in trauma nurses Methods: A systematic integrated literature review study was conducted using Ebscohost …

Cultivating A Culture Of Compassion Among Newly Graduated Registered Nurses: An Evidence-Based Mobile Learning Toolkit, Benson Yeung

Doctor of Nursing Practice (DNP) Projects

Empathy, kindness, and compassion are some of the humanistic values essential to nursing practice particularly in today’s patient and family-centric healthcare environment. A genuinely empathetic and caring relationship between a nurse and a patient not only enhances the quality and safety of care but also contributes to patient satisfaction, compliance to treatment, and overall health outcomes. Debate amongst educators and researchers continues to grow as to whether these uniquely humanistic values are innate or if they can be taught. How do nurses acquire the knowledge, skills, and attitudes towards the delivery of compassionate patient care? What strategies are best suited …

Aligning Theory And Evidence-Based Practices To Enhance Human Flourishing In Nurse Executives, Jim D'Alfonso

Doctor of Nursing Practice (DNP) Projects

Today’s nurse executives lead highly complex and bureaucratic organizations undergoing sweeping reform at an unprecedented rate of change. Change and high levels of stress are the norm in health care, and ineffective stress management can hinder organizational performance and adversely impact personal wellbeing. The risks of nurse executive burnout and unprecedented turnover led to the development of a 4-hour program to teach theory-guided and evidence-based stress management techniques. The program was intended to increase awareness, enhance effective stress management skills, and improve the nurse executive’s ability to flourish in high stress environments. A pre-intervention and 6-month post-intervention assessment (n …

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that demonstrate delivery of …

The Application Of Grounded Theory: An Example From Nursing Workforce Research, Latoya J. Lewis-Pierre 4572586, Joann Kovacich, Linda Amankwaa

The Qualitative Report

The application of grounded theory was the conduit to theory development in this study. The intent was to explore nurse manager, educator, preceptor, and new graduates’ perceptions of workplace readiness for new graduates entering an Intensive Care Unit. Research participants were drawn from five different ICUs: Medical, Coronary Care, Surgical, Neuroscience, and Trauma. One-on-one interviews were conducted to collect participants’ perspectives on readiness to practice in the ICU. Using grounded theory, four themes emerged giving rise to the novice nurse embracing the ICU theory (NNEIT). Reflections on the type of grounded theory used, reasons for the selection, challenges faced in …

Screening, Brief Intervention And Referral To Treatment Implementation In The Emergency Department, Arvind Venkat Md, Gary Shank Phd, Sherry Rickard-Aasen, Janice Pringle Phd, William Johnjulio Md

The Qualitative Report

We sought to qualitatively evaluate impediments in implementing a novel Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol into normal emergency department (ED) workflow for patients with at-risk drug/alcohol behavior. From 2010, administrative and nursing champions trained nurses at a single ED (census: 50,000 visits/yr) in SBIRT and incorporated SBIRT into normal ED nursing workflow in 2012. To qualitatively analyze impediments in SBIRT implementation, we created a semi-structured questionnaire for protocol champions with subsequent follow-up. Investigators analyzed responses using qualitative methodology based on a modified grounded theory framework. In 2012, 47693 visits by 31525 patients met SBIRT protocol initiation …

Risk Of Medication Errors In The Home: An Integrative Literature Review, Maria M. Crescenzi

Honors Undergraduate Theses

Regardless of the setting, medication errors are of great concern when associated with an individual’s health outcomes, along with the increased costs to society, healthcare institutions, and providers. Current research focuses on medication error data primarily in acute and extended care facilities. However, there is a paucity of research examining the causes of medication errors that occur post hospital discharge when individuals transition to the home. The purpose of this integrative literature review is to examine risk factors for medication errors outside of these settings, specifically in the home. A systematic literature search was conducted using multiple databases for relevant …

Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace

Doctor of Nursing Practice (DNP) Projects

Abstract

Discussed for decades, the need for transitional experiences bridging educational and practice settings gained momentum in the mid-1970s with the release of Kramer’s groundbreaking book Reality Shock: Why Nurses Leave Nursing. Nursing student internship programs were developed in the 1970s as one effort to address this issue. The Northern California Region of Kaiser Permanente partners with five universities to conduct the Nursing Student Work-Study Internship Program (WSP). The program provides senior level nursing students with a paid internship in clinical practice settings, working under the supervision of RN preceptors. The aim of the program is to improve the …

Increasing Chlorhexidine (Chg) Daily Bathing Compliance, Jonathan Lee

Master's Projects and Capstones

Chlorhexidine gluconate (CHG) daily bathing in hospitalized patients in the intensive care setting is one of many interventions implemented by institutions to reduce and prevent central line associated bloodstream infections (CLABSIs) and catheter associated urinary tract infections (CAUTIs). These hospital-acquired infections (HAIs) plague and complicate treatments for critically ill patients in the acute care setting. CLABSIs and CAUTIs increase patient morbidity and mortality as well as place a financial burden with increased costs and hospital lengths of stay. The decrease of CHG compliance in our ICU unit can be associated with an elevated CLABSI rates. The focus of this CNL …

Standardization Of Body Imaging Huddle In Radiology, Margaret M. Browne Mcmanus

Master's Projects and Capstones

Mag Browne McManus

Clinical Nurse Leader Abstract

University of San Francisco

Abstract

Communication amongst healthcare providers is critical to reducing errors, and in procedural areas, the huddle can be used to standardized communication amongst the team before the beginning of interventional procedures (Goldenhar, Brady, Sutcliffe, Muething, & Anderson, 2013). Prior to the implementation of the revised huddle, a staff survey indicated none of the staff were satisfied with the current process. The objectives of the standardization of the body imaging huddle in the department of radiology were to increase staff satisfaction by 15% and reduce the time from patient arrival …

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects and Capstones

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys were …

Faculty-To-Faculty Incivility As Perceived By Nursing Faculty, Melinda Lofton Sills

Dissertations

The purpose of this research was to determine the perceived presence of workplace incivility among nursing faculty in associate, baccalaureate, and graduate nursing programs and whether there was a significant difference between workplace incivility behaviors, occurrence of incivility, extent of incivility, and engagement of incivility among the three groups. A convenience sample of faculty from nursing programs accredited by Accreditation Commission for Education in Nursing and Commission of Collegiate Nursing Education in Alabama, Arkansas, Florida, Louisiana, and Tennessee completed the Incivility in Nursing Education-Revised (INE-R) survey. The final sample included 169 nursing faculty.

Based on the results of the study …

Leadership Practices Of Supervisory Employees: An Exploration Of Current Practices At A Southeastern Veterans Affairs Medical Center, Melissa M. Zimmerman

Electronic Theses and Dissertations

As the nation’s healthcare system moves through the 21^st century, unprecedented changes are occurring on both a local and global stage. Healthcare organizations are faced with creating and implementing leadership strategies to enhance the overall patient experience. When coupled with the need to ensure increased nurse job satisfaction, improved cost-effectiveness and healthy organizational cultures with fiscally sound budgets, improvement work has led efforts to ensure effective leadership techniques are used across an agency.

This task may be viewed as commonplace for some organizations, while others may perceive this process as a complete paradigm shift from historical practices related to …

Personal Protective Equipment Use For Patients With Clostridium Difficile, Mallory L. Compton

Scholars Week

In researching the literature on correct PPE by healthcare staff when a patient has C. diff. I have found that the policy on PPE for patients with C. diff at Baptist Health Paducah is compliant. The theoretical framework used for this research is that of Imogene King. Their policy is evidence based and is also cost effective when it comes to preventing the spread of infection from patient to patient. There is no need for change to this policy at this time because it is supported by evidence in the literature.

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Enhancing Nurse-Physician Communication And Collaboration, Pamela D. Missi

Graduate Theses, Dissertations, and Capstones

In healthcare organizations today, creating a culture of safety is critically important. Communication failures among healthcare providers have been linked to 70% of annual sentinel events. Seventy-six percent of individuals experiencing a sentinel event die (Joint Commission, 2009). Lack of good communication behavior between nurses and physicians has been recognized as a cause of preventable harm to patients (Institute of Medicine, 2004; Zwarenstein & Reeves, 2006). In hospital settings, communication failures are linked to increases in length of stay, patient harm, resource utilization, more rapid turnover, and caregiver dissatisfaction (Dingley et al., 2008). Numerous national organizations and commissions have officially …

A Causal-Comparative Inquiry Into The Significance Of Implementing A Flipped Classroom Strategy In Nursing Education, Rhonda Faretta

Doctoral Dissertations and Projects

The purpose of this causal-comparative design study was to examine the application of the theory of Vygotsky’s social constructivism (1978) and McMillan and Chavis’s (1986) definition of sense of classroom community in the context of a flipped classroom. The researcher aimed to determine if a pathophysiology course taught with the flipped classroom method would result in a statistically-significant difference in nursing students’ academic performance and sense of classroom community when compared to a pathophysiology course taught with the lecture classroom method. Two questions were addressed during this study: (a) Is there a statistically-significant difference in nursing students’ academic performance (as …

Retention Of Cardiopulmonary Resuscitation Knowledge And Psychomotor Skill Among Undergraduate Nursing Students: An Integrative Review Of Literature, Fernanda Tirado

Honors Undergraduate Theses

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: …

Post Foley Removal Guideline Process And Outcome Evaluation, Sarah E. Gabbard

DNP Projects

When patients are admitted to a hospital patient safety should be a priority in all aspects of the care they receive. Preventing patients from acquiring hospital infections (HAIs) is one example of patient safety. All hospital employees have the responsibility to ensure that standard workflow and processes are in place to ensure this safety. The purposes of this Practice Inquiry Project (PIP) were to examine and develop interventions to decrease the risk of catheter associated urinary tract infections (CAUTIs), incorporate an effective process and standard workflow to implement evidence practice practices (EBP), and to evaluate the effectiveness of implementing the …

Preventing 30-Day Readmissions Of Clostridium Difficile Patients Utilizing Targeted Discharge Instructions, Keith A. Howard

Doctor of Nursing Practice (DNP) Projects

The Patient Protection and Affordable Care Act of 2010 ushered in a new era of fiscal accountability for healthcare organizations. Healthcare organizations and providers are now jointly held responsible for the improved quality of patient care and sustained reductions in patient care events termed healthcare-acquired conditions. To ensure compliance with this newly enacted legislation, the Centers for Medicare and Medicaid Services (CMS) began penalizing hospitals for targeted conditions leading to 30-day readmissions beginning in October 2012. Annually, CMS has focused attention on conditions that endanger patient health and welfare while secondarily attempting to reduce the excessive financial expenditures in …

Student Nurse Behaviors And Barriers To Successful Completion Of The Traditonal Bachelor's In Science Of Nursing (Bsn) Program., Carri Shaw

Honors Theses

Change is often said to be the only constant in life. This holds true to the rapidly growing field of nursing. In order to meet the demands of new challenges that emerge in nursing, the way future nurses are educated also has changed. Not all nursing students find that the profession is for them. Therefore, some attrition from school is expected. This descriptive study will explore factors that the literature suggests are related to attrition at a mid-sized public university in the Midwest. A survey given to two different level nursing cohorts will give insight to pre-licensure nursing students’ experiences …

Nurses’ Knowledge And Attitudes Toward Implementation Of Electronic Medical Records, Cathy H. Abell, Tonya Bragg-Underwood, Lori Alexander, Caitlyn Elizabeth Abell, Vanessa Burd

International Journal of Faith Community Nursing

With the growth of Faith Community Nursing (FCN), one topic that needs further exploration is documentation. This includes the use of electronic medical records (EMRs). Nurses play a vital role in the planning and implementation of EMRs in the acute care setting and will also play a key role in Faith Community Nursing Programs that stand alone or partner with a health care agency. Individual computer expertise and/or attitude and knowledge of EMRs could be important in the successful implementation. Researchers utilized a modified version of the EMR questionnaire designed by Beiter and colleagues to examine nurses’ knowledge and attitudes …

Improving Patient Satisfaction Through Reducing Nurse Overtime And Redesigning Nurse Staffing And Scheduling, Abby Romme

Master's Projects and Capstones

Increasing cardiac device patient demands within a large Midwest healthcare institution resulted in significant increases in staff shift requirements and corresponding patient complaints. The quality improvement project aimed to decrease patient complaints by executing a standard baseline daily full time equivalent (FTE) staffing strategy for future schedules, increasing nursing FTE, and maintaining institutional staffing standards. Standard calculated daily nursing requirements targeted 17.0 FTE. Implementation occurred over a three month period including schedule reprocessing, a pending incremental nursing FTE request, and a restructuring of unit based scheduling and paid time off guidelines. The completed schedule accurately captured staffing requirements for 100% …

Simulation And Educational Strategies To Decrease The Incidence Of Medication Errors In A Small Rural Acute Care Hospital, Queen Victoria Walters

Doctoral Projects

The Institute of Medicine (IOM) estimates 1.5 million medical errors occur per year (2007). Medication errors are the leading medical error. Medication errors are defined as adverse drug events, and are 100% preventable. Some categories of adverse drug events include, medications administered at the wrong time, by the wrong route, using the wrong method of administration, and administration of the wrong dose of medication. Adverse drug events also include administration of an overdose of medication or the omission of medications as well as administering the wrong medication.

The purpose of this capstone project was to increase the competency of nurses …

Elevating Research: An Important Role For Nurse Leaders, Katreena Collette Merrill, Diane Andrews, Barbara B. Brewer, Diane Storer Brown

Faculty Publications

As leaders, we recognize the importance of professional scholarship to provide the evidence needed to transform practice. One key initiative for the American Organization of Nurse Executives (AONE) is the elevation of nursing research and AONE competencies for nurse executives emphasize utilization, dissemination and participation in studies. However, given our current healthcare climate and competing priorities, nurse leaders must often focus efforts on fiscal responsibility and operational effectiveness, making time and resources to support nursing research challenging. Initiatives that do not directly impact patient care, such as research, may be given a lower priority. Given today’s pressures, nurse leaders may …

Leadership Style And Patient Safety: Implications For Nurse Managers, Katreena Collette Merrill

Faculty Publications

OBJECTIVE: The purpose of this study was to explore the relationship between nurse manager (NM) leadership style and safety climate.

BACKGROUND: Nursing leaders are needed who will change the environment and increase patient safety. Hospital NMs are positioned to impact day-to-day operations. Therefore, it is essential to inform nurse executives regarding the impact of leadership style on patient safety.

METHODS: A descriptive correlational study was conducted in 41 nursing departments across 9 hospitals. The hospital unit safety climate survey and multifactorial leadership questionnaire were completed by 466 staff nurses. Bivariate and regression analyses were conducted to determine how well leadership …

Diabetic Prevention The Hard Way: Modified Diet And Increased Exercise, Torrie Reese St.Julien

Doctor of Nursing Practice Final Manuscripts

Background and Purpose: In the United States, 79 million people are pre-diabetic: most have no symptoms. If left untreated, 37% will develop diabetes within 4 years. Fourteen percent of United States health care expenditures are related to diabetic complications. This Evidenced Based Project (EBP) involved a behavioral lifestyle change with the purpose of 7% weight loss and a minimum of 150 minutes of physical activity a week. It was also designed to reduce risk factors and glycated hemoglobin A1c (HgA1c) levels.

Methods: The interventional approach was modeled after the Diabetes Prevention Program (DPP) and Group Lifestyle Balance Program. Participants were …

An Investigation Of The Relationships Between And Among Power, Trust And Job Satisfaction Of Nurse Managers In Acute Care Hospitals Using Rogers Science Of Unitary Human Beings, Maureen A. Schneider

Seton Hall University Dissertations and Theses (ETDs)

Background: Defined as control and freedom, power is often characterized as hierarchical. Power-as-freedom exists as a unitary manifestation of the whole and is acausal. Thus a worldview that emphasizes mutual process rather than a causal (control) view supports a culture of trust in the healthcare environment that generates a committed and a thriving work force. When nurse leaders support a climate of trust, managers develop a sense of commitment to the organization which may lead to job satisfaction. However, there is a lack of empirical evidence supporting the relationship between power, trust and job satisfaction among nurse managers.

Purpose: The …