Evaluating The Burnout Mitigating Effects Of A Structured Mentorship Program In Newly Hired Advanced Practice Providers, Melissa Soper

DNP Projects

Importance: Burnout is a leading driver of clinician intent to leave, lower productivity, increased medical errors, and increased resource use.

Objective: The purpose of this project was to evaluate the effects of an evidence-based mentorship program on newly hired advanced practice providers’ (APPs’) level of stress, burnout, and professional fulfillment.

Results: At baseline, APPs demonstrated higher stress levels, moderate professional fulfillment, and low burnout. Outcomes showed improvement at the end of a mentorship program.

Conclusion: Longitudinal studies with larger sample sizes are needed to determine the true effect of a 6-month mentorship intervention on APP burnout, stress, and professional fulfillment.

Establishing An Advanced Practice Provider-Led Transient Ischemic Attack Clinic: A Quality Improvement Initiative, Brittany A. Young

DNP Projects

Background: Due to lack of subspecialized neurological care in many rural community settings, care in tertiary hospitals is in demand. Insufficient care pathways can lead to lack of bed and provider availability. Advanced Practice Provider Transient Ischemic Attack clinics have been shown to be safe alternatives to hospital admission, for patients who meet criteria. This study targeted practice change at a 1000 bed tertiary academic hospital.

Methods: The quasi-experimental study sample inclusion criteria included Transient Ischemic Attack patients presenting to the emergency department with an ABCD2 < 4, complete symptom resolution, and no new cardiac changes on monitoring. A pre and post survey with educational PowerPoint intervention was provided to all emergency department and Neurology providers and nurses. A Transient Ischemic Attack clinic was established with a corresponding order set to be utilized for streamlined outpatient work up.

Results: During the pilot period, 29 admissions were deferred with 69% …

Stronger Together: Exploring The Impact Of Peer Support Meetings On Stress And Burnout In Ambulatory Nurse Managers, Sara Wellman

DNP Projects

Background

Nurse manager (NM) burnout is common and leads to decreased staff productivity, departmental effectiveness, and leadership capacity. This results in decreased staff morale, poor conflict management, and ineffective communication. Stress reduction and resilience programs have been shown to reduce burnout and enhance resilience in NMs, but more focus needs to be directed toward NMs who work in ambulatory settings.

Purpose

The aim of this project was to evaluate the effectiveness of a peer-to-peer resilience intervention in reducing stress and burnout among ambulatory nurse managers.

Methods

This project used a pre-test/post-test survey design and a convenience sample of ambulatory NMs. …

Effectiveness Of A Multi-Departmental Nursing Tiered Orientation Model On Service Line Culture, Self-Efficacy Of Nurses, Positive Patient Outcomes And Nurse Satisfaction, Kimberly Thompson

DNP Projects

Abstract
Background: Nurses who transition into specialty practice areas in healthcare settings may demonstrate a lack of confidence and a high level of stress. Decreased levels of nursing engagement, self-efficacy, and interdepartmental team collaboration may also be seen. Multi-departmental tiered orientation models can help facilitate the development of increased confidence and competence and ultimately lead to improved patient outcomes.

Purpose: The purpose of this doctoral project was to evaluate the effectiveness of a multi-departmental tiered orientation model for nurses hired into a specialty area. The specific objectives included were to a) determine the effectiveness of the model on service line …

Evaluating The Effect Of A Mindfulness App On Pediatric Nurses Caring For Adolescent Patients Diagnosed With Disordered Eating, Kaitlyn Green

DNP Projects

Abstract

Background. The health and wellbeing of nurses are affected by the demands of their workplace and the people that they care for. In turn, nurses’ wellbeing affects their work and patient outcomes. There are opportunities to address certain workplace structures, systems, and policies that create stressors and lead to burnout, fatigue, and poor mental and physical health. For nurses to continue to provide quality care in environments that have increasing demands, they must first feel healthy, well, and supported themselves. Healthcare leaders have a role in ensuring the wellbeing of their nursing staff. Compassion fatigue is a large focus …

The Impact Of Code Lavender On Compassion Fatigue And Burnout Of Pediatric Bedside Staff, Sara L. Castle

DNP Projects

Background: Compassion fatigue is a significant problem in healthcare that can impact staff retention, job satisfaction, and patient outcomes. Code Lavender combats compassion fatigue by serving as a crisis intervention tool using evidence-based relaxation techniques, paired with increased support from Leadership.

Purpose: The purpose of this project was to evaluate the impact of Code Lavender on reported levels of compassion fatigue and burnout amongst pediatric bedside staff working on a 12-bed progressive care unit at a Children’s Hospital in a large Academic Medical Center.

Method: This study employed a pilot evaluation design, consisting of pre- and post-surveys utilizing questions from …

Evaluation Of A Brief Mindfulness-Based Intervention Of Work-Related Stress, Job Satisfaction, Retention, And Quality Care: A Quality Improvement (Qi) Project, Laura M. Bragg

DNP Projects

Burnout among advanced practice providers (APPs) remains a significant concern nationally and within the University of Kentucky Healthcare system, with post-COVID evidence showing persistently elevated stress and emotional exhaustion. This quality improvement (QI) project implemented and evaluated a brief, app-based mindfulness intervention using the Headspace “Learn the Basics of Meditation” program for work-related stress, job satisfaction, mindfulness, and retention intentions among APPs. A one-group pre-post design was implemented, with 45 APPs completing the pre-intervention survey and four completing both the pre- and post-intervention surveys. Although no statistically significant improvements were observed, nonsignificant decreases in emotional exhaustion, fatigue, and turnover intention …

Veterans Direct Admission Reassessment Tool Validation For The Reduction Of Rapid Response Code Blue, And Code Stroke Team Activations In Newly Arrived Direct Admission Veterans, Joshua Monroe Wells

DNP Projects

Abstract

Purpose: Rapid clinical assessment of newly arriving direct admission veteran patients to the Department of Veterans Affairs Health Care System (VAHCS) Lexington is of the utmost importance to determine current patient condition, alteration from previously known condition at time of provider acceptance or time of report, and appropriate level of care for these veterans. The facility has seen an increase in the number of unexpected patient declines by direct admission patients presenting to medical surgical units at the VA Health Care System Lexington KY. This recurrent decline resulted in the facility performing a Root Cause Analysis (RCA), which identified …

The Impact A Nurse Recruiter Has On Nursing Staff Shortages And Nurse Manager Satisfaction In An Acute Psychiatric Facility, Johna Arnett

DNP Projects

Abstract

Background: Nursing staff shortages have persisted for the last few decades. Strategies to resolve this enduring challenge continue to drive the creative efforts to attract and retain new staff. These shortages not only affect patient care but can also impact the satisfaction of nurse managers. Little information is available on the effects of a nurse recruiter role on nursing staff shortages as well as nurse manager satisfaction.

Purpose: The purpose of this project is to assess how implementing a designated nurse recruiter impacts nursing staff shortages and nurse manager satisfaction in an acute psychiatric facility. This project examines two …

Reducing Nursing Documentation Burden: Evaluation Of An Electronic Health Record Optimization Plan, Jessica Collins

DNP Projects

Background: UK HealthCare transitioned to a new enterprise electronic health record (EHR) system, offered by Epic Systems Corporation, in June 2021. Approximately 2,000 inpatient nurses use the EpicCare Inpatient Module in the 1,086 licensed bed facilities. Compared to other academic medical centers, UK HealthCare nurses take more time documenting in this EHR inpatient module’s Basic Assessment Flowsheet (documentation burden) and have a longer delay between assessment and documentation (timeliness) potentially contributing to nursing dissatisfaction with using this new EHR.

Purpose: The purpose of this project was to evaluate the effectiveness of a phase of the Epic Nurse Well-Being Project, a …

New Crew Nights: The Impact Of A Nurse Leader Led Mentorship Series On Perceived Competency In The Novice Nurse, Taylor C. Bergman

DNP Projects

Abstract

Background and Purpose: Nursing leaders across the United States are seeking to recruit and retain new graduate nurses as a national nursing shortage widens at an alarming pace. Healthcare systems are tasked to strengthen the skill set of novice nurses as they seek to meet the care needs of acutely ill patients and rebuild a skilled workforce for future years. This study evaluated the impact of a four-part mentorship series for novice nurses on perceived strengths in competency, communication, wellbeing, and teamwork.

Methods: In this quality improvement project with pre-intervention/post-intervention assessment, a sample (n=14) of medical surgical nurses with …

Nurse Management Competency Training For Frontline Nurse Leaders, Travis Drake

DNP Projects

Background: Growing evidence shows that front line nurse leaders take on their role with minimal education and training. Healthcare facilities are pressed for resources and time to allow for proper development of these leaders.

Purpose: The purpose of this project was to provide novice nurse leaders with a condensed management development program utilizing key American Organization of Nurse Leaders (AONL) nurse manager competencies. This abbreviated program was developed focusing on three key competencies of finance, innovation, and human resources. The impact of the program was measured by comparing self-assessment prior to any of the education and after the entire program …

Addressing The Inpatient Penicillin Allergy And Antibiotic Stewardship: The Effect Of Education On Compliance Rates Of The Nurse Driven Penicillin Allergy Assessment Tool, Alexandria Bassler

DNP Projects

Background: Penicillin allergies are the most frequently reported drug allergy but less than 1% of the total population has a true immune-mediated allergy. Patients who are labeled as having a penicillin allergy may receive drugs that are less effective, more costly, and more toxic. The nurse driven penicillin allergy assessment tool strives to increase penicillin allergy de-labeling rates by pharmacists and providers.

Objective: The purposes of this study were to (1) perform a retrospective and prospective chart review to determine compliance rates with the nurse driven penicillin allergy assessment tool, (2) provide an education module on antibiotic stewardship …

Modified Early Warning Scoring (Mews) Versus Epic Deterioration Index (Edi): Battle Royale For Which Has The Best Patient Outcomes In The Inpatient Setting, Dirk A. Church

DNP Projects

Abstract

Background: The increased workload bedside nurses face today requires new tools to assist with the identification of deteriorating patients during hospitalization. The Modified Early Warning Score (MEWS) tool has formed the background of early warning tools. Newer, more complex tools, like Epic’s Deterioration Index (EDI), have been developed to identify patient deterioration earlier. There is lack of evidence in the literature comparing different early warning tools, implementation, and patient outcomes.

Objective: The purpose of the study was to examine models for EWS notification for RRT and patient outcomes between the use of the MEWS and EDI in an adult, …

Patient Transitions Between Acute And Post-Acute Care Organizations: Can Nursing Communication Prevent Patient Readmission?, Penny Gilbert

DNP Projects

Preventing Patient Readmission

Background and Review of Literature: Communication is the foundation of patient safety. As patients move from the acute to post-acute care setting, risk for insufficient communication rises. Research demonstrates a vast array of communication hand-off tools currently exist for and between different care arenas. No one tool has been standardized for patients transitioning from acute to post-acute care settings. The Institute of Medicine (IOM) and The Joint Commission (TJC) have published multiple documents discussing communication plagues within health care resulting in readmission.

Purpose: The purpose of this project is multifaceted: 1) identifying current nursing communication practices between …

Evaluation Of Dyad Effectiveness In A Psychiatric Healthcare Facility, Elizabeth Smith

DNP Projects

Background: Inadequate communication can lead to poor quality of care and patient outcomes. Physician-nurse dyad partnerships have been shown to increase effective communication but there is a lack of data to show the impact these dyads have on dyad members’ perceptions about patient safety, work engagement and quality patient outcome measures.

Purpose: This purpose of this project was to determine if a physician-nurse dyad structure in an inpatient psychiatric hospital would lead to improved participant perception about patient safety, work engagement, and patient quality outcomes.

Methods: A quasi-experimental pretest-posttest design was used. Participant perceptions related to patient safety, work engagement, …

The Effect Of An Educational Intervention On Clinical Rn Knowledge And Attitudes Toward Shared Governance Program At Eastern State Hospital, Tanna Mckinney

DNP Projects

Background: Shared governance programs are a popular way to improve Registered Nurse (RN) engagement and retention. These programs are notoriously difficult to garner and maintain participation. However, successful shared governance can improve patient outcomes, patient satisfaction and RN engagement.

Conceptual Framework: The theory of planned behavior was used as the conceptual framework for this study. This theory posits that attitudes, subjective norms, perceived behavioral control and intentions towards a behavior can predict behavioral achievement.

Methodology: Eighty clinical registered nurses were invited to voluntarily complete a survey to determine current attitudes about shared governance and intent to participate in shared governance …

The Measurement Of The Impact Of Well-Being Resources On Moral Distress And Burnout Following The Covid-19 Pandemic In Front-Line Nurse Leaders, Benjamin Hughes

DNP Projects

Background: Due to the COVID-19 pandemic, there is significant burnout among front-line nursing staff. Little literature has been published about the measurement of burnout among front-line nursing leaders, such as nurse managers and directors, nor the interventions used to help with this ever-growing issue among this group. Since the pandemic began, there have been many resources identified to help front-line staff members with burnout, but none specifically looking at what has worked or been utilized by front-line nursing leaders.

Purpose: The purpose of this project was to describe what well-being resources were identified as being effective in decreasing moral distress …

The Effect Of Relational Aggression Training On New Emergency Department Nurses, Mary Wethington

DNP Projects

BACKGROUND: Relational aggression (RA) in nursing is widespread. One group often at risk for exposure to RA is the newly licensed nurse. RA can lead to a negative work environment which can cause poor patient outcomes and high nurse turnover.

PURPOSE: The purpose of this study was to evaluate the effects of an educational program on RA in the emergency department with newly licensed registered nurses. This was conducted using one pre and two post surveys. The surveys evaluated the nurses’ knowledge of RA self-awareness before and six weeks after an educational session.

METHODS: This was a single-site, single-unit pretest …

Examining The Impact Of Patient De-Escalation Techniques Training On Nurses' Feeling Of Safety, Raymond O. Young

DNP Projects

Abstract

Purpose: To evaluate the effects of patient behavioral verbal de-escalation techniques training on bedside nurses’ feeling of safety in the presence of an aggressive patient, and nurses’ confidence level in their ability to successfully de-escalate aggressive patient behavior prior to the patient becoming violent. Objectives of this study were to demonstrate increased feelings of safety and security in the workplace among nurses receiving patient de-escalation training once the training was completed; to improve the overall perception of mental health status of nurses; to improve the job satisfaction and likelihood to stay in their current position; and to assess the …

Increasing Confidence Of Nurses In Giving And Receiving Constructive Performance Feedback, Savanna Carroll

DNP Projects

Background: Nursing peer review is a process of reviewing standard nursing practice in an organization and comparing a nurse’s own practice to that standard. Nursing peer review contributes to the professional practice environment by assuring standard practice and competence, maintaining a culture of accountability, and maintaining psychological safety.

Purpose: The purpose of this project was to design and implement an educational intervention and simulation activity to prepare nurses to have constructive conversations with peers regarding work performance. Evaluation of the intervention would yield increased confidence and competence of nursing staff in giving constructive performance peer feedback.

Conceptual Framework: Bandura’s Social …

The Effect Of An Acuity Adaptable Unit On Efficiency In Non-Critical Trauma Patients, Rebecca Charles

DNP Projects

Problem Statement: It was observed a large academic medical center is experiencing impeding congestion of non-critical care patients due to challenges with bed availability and high patient volumes. Delays in transferring patients to an appropriate level of care can impose safety risks and prolong length of stay. Implementation of an acuity adaptable unit may be a cost-effective approach to a growing problem.

Background: A fixed bed model limits the acuity of patients admitted to a specific space. Using the Iowa Model of Evidence Based Practice as the framework for design, moving to an acuity adaptable unit could facilitate patient …

The Impact Of A Change In Leadership, Taylor Collins

DNP Projects

Abstract

Background: Unmitigated stress in nursing results in moral distress, burnout, turnover and poor patient outcomes. Authentic leaders can improve the nurses’ work environment and satisfaction by improving communication and implementing supportive measures.

Purpose: The purpose of this study was to determine whether a change in executive leadership at BSW Grapevine Medical Center reduced nursing job stress as evidenced by improved nurse satisfaction, nurse retention, nurse engagement, patient satisfaction and care outcomes.

Conceptual Framework: Watson’s Theory of Human Caring

Design: This study is a quantitative, descriptive retrospective measurement of two points in time, before and after …

The Effect Of Multimethodological Emotional Intelligence Training On Emotional Intelligence Levels In Nurses At An Academic Medical Center, Chad Eldridge

DNP Projects

Background: Stress levels associated with the nursing career can be amplified by hostile social environments in the workplace, horizontal aggression, lack of leadership support, and poor communication. This can lead to poor retention rates and increased burnout.

Conversely, supportive work environments positively influence nursing sensitive quality indicators such as patient satisfaction, nosocomial infections, patient falls, pressure ulcers, and medication errors. Strong relationships enhance workplace social capital leading to an increased sense of belonging, strengthened mental health, and improved job satisfaction ratings.

Executive nurse leaders can promote an empowering environment dedicated to the physical, mental, and social well-being of their staff …

Health Priorities, Current Lifestyle Behaviors, And Barriers To A Healthy Lifestyle Among Emergency Department Nurses, Shannon C. White

Theses and Dissertations--Kinesiology and Health Promotion

Background: Emergency nurses are tasked with managing the hectic, unpredictable, and constantly changing environment of an ED. In addition, emergency nurses have been shown to have high levels of stress, irregular meal schedules, rotating shift work, long hours, and a lack of physical activity. Furthermore, research has suggested that nurses are at an increased risk for non-communicable diseases, such as diabetes, hypertension, and coronary heart disease (Phiri, et al., 2014), in addition to a high prevalence of obesity (Kyle, et al., 2016).

Methodology: In this study, 23 emergency nurses completed a 43-item survey regarding current behaviors and constructs of …

The Effects Of Mindfulness Practices On Nurse Leader Resiliency, Kimberly Blanton

DNP Projects

Background: The purpose of this study was to evaluate if brief Mindfulness Based Stress Reduction (MBSR) sessions can improve nurse leader resilience and overall mindfulness.

Conceptual Framework: Two different conceptual frameworks, Jean Watson’s theory of caring and Albert Bandura’s theory of self-efficacy, were used to guide this project. Watson’s theory of caring is defined as healing of the mind, body, and spirit. This theory supports caring for oneself while caring for others. Bandura’s theory focuses on the belief that individuals can influence their own lives.

Methodology: This study employed a descriptive, pretest-posttest single site comparative design. Sixty-six nursing leaders from …

Evaluation Of The Effectiveness Of A System Based Nurse Manager Collaborative Council On Work Engagement, Psychological Empowerment, And Value, Stacy Colligan

DNP Projects

BACKGROUND: Nurse Managers often do not receive direct acknowledgment for their accomplishments or have input into the facility wide decisions which directly impact them. Currently there are no known shared governance programs tailored to the nurse manager level.

PURPOSE: To determine the impact of a system shared governance model on nurse manager’s work engagement, psychological empowerment, and inclusion.

METHOD: A pretest and posttest design was utilized to determine the impact of shared governance participation for nurse managers. Spreitzer’s psychological empowerment scale and the Ultrech “Work and Well-being” instrument, in addition to some Likert scale and open-ended descriptive questions, were included …

Evaluation Of The Effect Of Milner-Fenwick Video-Based Education And Teach-Back On Knowledge Acquisition In Atrial Fibrillation Patients, Melissa Czarapata

DNP Projects

PURPOSE: The purpose of this study was to evaluate if video education impacts knowledge acquisition and health literacy in patients with atrial fibrillation. METHODS: This study employed a descriptive, pretest-posttest single site comparative design. Baseline health literacy was assessed before video education was completed using the Atrial Fibrillation Knowledge scale. Health literacy regarding atrial fibrillation was again assessed for the same participants immediately after video education was completed and again in 7 to 10 days through the use of the Atrial Fibrillation Knowledge scale and teach-back questions. RESULTS: There was no statistical significance found when comparing scores before and after …

Nurse Executive And Middle Management Leadership Competency Assessment Within A Multi-Hospital System, Rachel Inyama

DNP Projects

BACKGROUND: Nursing leaders face increasing pressure to meet multiple outcomes and maintain standards of care while protecting the organization from potential financial consequences if standards or goals are not met. To meet the mounting demands, both nurse executives and middle management leaders will require the development of new skill sets not historically included in the job description.

PURPOSE: The purpose of this study was to assess the competencies of nursing leaders at the executive and middle management levels within Norton Healthcare.

METHODS: This study was a descriptive cross-sectional survey design to measure Chief Nursing Officer and Nursing Director leadership competencies. …

Change In Falls And Sitter Cost Post Implementation Of Remote Centralized Video Monitoring In Hospitalized Adult Patients, April Nicole Dougherty

DNP Projects

PURPOSE: Falls are the leading cause of injury in hospitalized patients. Patient sitter programs are proven to be an effective way to reduce falls in hospitalized patients. Innovative technologies have been examined that provide a safe and cost-effective way to reduce sitter costs and prevent falls. An innovative technology option is a remote centralized video monitoring system containing one video monitoring technician watching and verbally redirecting multiple patients at one time using mobile cameras. The purpose of this project is to evaluate the implementation of a remote centralized video monitoring system for adult patients in the acute care hospital setting. …