Nursing Administration Commons^™

An Evaluation Of A Pilot Inpatient Hospice Unit And The Impact It Has On End-Of-Life Care At An Academic Medical Center, Cynthia Minetree

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Research shows that acute care hospitals with inpatient hospice units have an increase in hospice resource utilization and provide end-of-life care that is more aligned with patients’ end-of-life goals compared to hospitals that do not have inpatient hospice units.

Methods: A pilot six-bed General Inpatient (GIP) hospice unit was implemented at an acute care hospital, located in Washington, D.C., to provide hospice care for patients that were not able to transfer to another inpatient setting for hospice care. A six-month evaluation of the pilot GIP hospice unit was done to evaluate the feasibility of the unit and the impact …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …

The Impact Of A Revised Discharge Process From Acute Care To Home Care On Hospital Utilization In Children With Single Ventricle Heart Disease, Brian M. Stahulak

Doctor of Nursing Practice Projects

Problem Description: It is estimated that approximately ~0.5%, or ~400,000, of all U.S. children, are identified as having complex chronic conditions (CCC) and account for as much as one-third, or ~$100 billion, of health care spending for all children. The goal of this quality improvement (QI) project was to identify the impact of a revised discharge process for children with Single Ventricle Heart Disease (SVHD) on hospital utilization rates and the parent’s perception of discharge readiness during the interstage period. The QI project was conducted in a 44-bed cardiac care unit within a 336-bed freestanding pediatric, academic medical center in …

Mentorship Through Storytelling Program, Debra Marie Perry

Theses and Graduate Projects

The Mentorship Through Storytelling Program began in response to an urgent need to reduce registered nurse (RN) turnover rates and improve nurses’ satisfaction on a medical surgical unit in a Midwestern Hospital. The unit was challenged to hire, integrate, and retain a multigenerational team of RNs. Guided by Jean Watson’s Theory of Human Caring, the Mentorship Through Storytelling Program was initiated in the fall of 2018 after doing a broad literature review and adapting the Academy of Medical Surgical Nurses’ Mentorship Program to include the concepts of storytelling, mentoring, and caring. Digital recordings of five expert nurses’ oral histories (stories) …

Implementation Of Safe Patient Toileting To Decrease Patient Falls On Medical-Surgical Unit, Kimberly A. Goldsborough

DNP Scholarly Projects

BACKGROUND: Patient falls are a serious safety concern in the hospital setting throughout the country. Falls are one of the most challenging patient safety events to prevent, as there are many contributing factors with toileting activities producing the highest incidence. Fall prevention bundles are used to minimize and reduce these such events although multifaceted. The project was conducted with an academic medical center on an acute inpatient medical-surgical unit primarily housing burn wound patients. Nursing leaders and front-line nursing staff participated.

METHODS: Literature review to determine the gap in knowledge of interventions to prevent acute inpatient falls was completed. Concepts …

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 …

Just Culture: It's More Than Policy, Linda Paradiso, Nancy Sweeney

Ellmer School of Nursing Faculty Publications

[Description] Paradiso and Sweeney discuss the relationship between trust, just culture, and error reporting in medical care. Errors rarely occur in a vacuum, rather they're a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. Just culture is a safe haven that supports reporting. In a just culture environment, organizations are accountable for systems they design and analysis of the incident, not the individual. The shift to a just culture is a slow process that takes years to develop and hardwire. Hospital-wide policies that incorporate …

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. …

The Effect Of An Education Plan On Nursing Intervention Compliance With Inpatient Post-Operative Colorectal Surgical Patients Using Enhanced Recovery After Surgery (Eras) Protocols, Jennifer Austin

DNP Projects

Abstract

BACKGROUND: Compliance with the enhanced recovery after surgery (ERAS) protocols for colorectal surgery patients in the post-operative inpatient setting is low, creating a gap in successful outcomes of the program.

OBJECTIVE: The purpose of this project is to evaluate the impact of an education plan on inpatient nursing staff. A second purpose of the study is to examine the relationship between ERAS and specific post-operative nursing interventions linked to length of stay (LOS).

METHODS: A prospective cohort study analyzing the effect of a knowledge to action (KTA) education plan on nursing compliance with ERAS protocols was conducted on bedside …

Impact Of A Change In The Assistant Nurse Manager Model On Satisfaction And Work Engagement, Frank Wilson

DNP Projects

PURPOSE: The purpose of this study was to assess the effectiveness of the Assistant Nurse Manager (ANM) model at Norton Hospital through an evaluation of job satisfaction, work engagement, and leader opinions about the ANM model.

CONCEPTUAL FRAMEWORK: Kurt Lewin’s Change Theory was used as the conceptual framework. Lewin’s Change Theory has three stages: unfreeze, change/transition, and refreeze.

METHODS: This study employed a descriptive, cross-sectional design.

RESULTS: This study included 27 participants [eight Nurse Managers and 19 ANMs]. The mean satisfaction level with being a nurse leader was 5.0 for nurse managers and 4.2 for ANMs (range 1-6). The mean …

The Effect Of An Emotional Intelligence Training Program On Use Of A Transformational Leadership Style Among Nurse Managers, Audrey Frias

DNP Projects

Background: Leaders with high levels of emotional intelligence have been associated with transformational leadership styles, which have been found to directly impact leader effectiveness. Emotional intelligence training has been deemed the most effective method for improving nurse manager emotional intelligence and transformational leadership by providing participants with the tools they need to be successful.

Conceptual Framework: Transformational leadership was used as the conceptual framework for this study and is defined as ‘‘a leadership process that is systematic, consisting of purposeful and organized search for changes, systematic analysis, and the capacity to move resources from areas of lesser to greater productivity …

An Assessment Of The Effectiveness Of A Safety Strategy Training Program On Knowledge Retention In New Nurses, Annette Mtangi

DNP Projects

Purpose: The purpose of this study was to assess the effectiveness of a lecture-based safety strategy training program on new nurses’ level of knowledge about how to reduce errors when providing patient care.

Conceptual Framework: Patricia Benner’s Novice to Expert model of knowledge and skill acquisition in nurses was the conceptual framework used for understanding how nurses acquire knowledge, skill and experience as well as their propensity for error at different stages of development.

Methods: This was a quasi-experimental pre-test, post-test assessment of the current lecture format. The instrument used was a survey that asked demographic, safety strategy knowledge, and …

The Effect Of Implementation Of A Nurse Manager Orientation Program On Nurse Manager Competency And Empowerment, Erin Coogan

DNP Projects

Background statement: Based on the role the nurse manager plays in improving quality outcomes, promoting staff and patient satisfaction, and creating the culture of the unit, it is vital that proper training is provided to new nurse managers to increase their competency and sense of empowerment.

Theoretical/Conceptual Framework: The theoretical/conceptual framework that provided the base for this study was Bandura’s theory of Self-Efficacy. A sense of accomplishment and overall well-being of a person is affected by a strong sense of efficacy.

Purpose Statement: The purpose of this project was to evaluate the effectiveness of a mandatory systemized nurse manager orientation …

Exploring The Narratives Of Black Male Nurses In Southeast Georgia: Implications For The Implementation Of Culturally Responsive Pedagogy In Nursing Curriculum, Celine M. Pfund

College of Graduate Studies: Theses & Dissertations

ABSTRACT

This dissertation inquiry explores the narratives of two Black male nurses in southeast Georgia. The framework for my research includes a variety of different theoretical components including works from both major nursing and curriculum studies scholars. The nursing workforce remains homogenized despite major recruiting. The intention of my research was to explore the experiences of Black male nurses to identify challenges, barriers, and systems of oppression that they may have encountered working in a profession dominated by White females in order to facilitate development of culturally responsive pedagogy in nursing. Methodologically, I mainly drew upon James Spradley’s work on …

Reduction In Hospitals' Readmission Rates: Role Of Hospital-Based Skilled Nursing Facilities, Shivani Gupta, Ferhat D. Zengul, Ganisher Davlyatov, Robert Weech-Maldonado

Faculty Publications

Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potentially preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days of discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented to reduce readmission rates. Prior research has shown that coordination of care could play a significant role in lowering readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving care for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association with hospitals’ …