Nursing Administration Commons^™

Hospital Acquired Pressure Injury (Hapi)– Related To Bilevel Positive Airway Pressure (Bipap) In Definitive Stepdown Unit (Dsu)​, Carmyle Seville, Bsn, Rn, Pccn, Angelica Taneca, Bsn, Rn, Pccn

Articles, Abstracts, and Reports

2023 Western Institute of Nursing Research (WIN)

Leveraging Technology to Advance Nursing and Equity in Research, Practice, and Education

HAPI-Related to BIPAP in DSU

Carmyle Seville, BSN, RN, PCCN

Angelica C. Taneca, BSN, RN, PCCN

Background: Most Medical-Device Related Pressure Injuries develop when skin or underlying tissues are subjected to a sustained pressure or shear from medical devices. Dressings have shown substantial biomechanical effectiveness in alleviating facial tissue deformations and stresses by providing localized cushioning to the tissue at risk. Our units (DSU and SDU) provides for the monitoring and care of patients with moderate or potentially severe physiologic instability …

Type 2 Diabetes Treatment Plan, Kylie N. Laird

MSN Capstone Projects

Diabetes affects more than 34 million Americans, with approximately 90-95 percent of them having type 2 diabetes. Diabetes is primarily managed by the patient with assistance from their healthcare team (Centers for Disease Control and Prevention, 2021). Diabetes is a costly disease that affects individuals, healthcare systems, economies, and entire societies globally. Based on the knowledge, lifestyle interventions have shown to be effective in the management of type 2 diabetes (Garcia, 2020), a more holistic approach to disease management was pursued. Garcia (2020) conducted a study in which lifestyle intervention data for treatment of diabetes was compared to pharmaceutical management …

Evidence Based Change To Improve Outcomes In Cardiac Patients, Amy L. Callahan

MSN Capstone Projects

According to the Centers for Disease Control and Prevention, “heart disease is the leading cause of death in the United States” (CDC, 2022). Modern healthcare has made numerous advances in changing the prevalence of heart disease and has shifted resources to promoting prevention. When a patient requires admission to an acute care facility for heart disease exacerbation, the focus is more of treating the acute process and how to manage the condition moving forward.

Although there have been a substantial number of resources that have been allocated to prevention in the primary care and outpatient setting, there is a need …

Mitigating Fatigue In The Triage Process: A Creative Solution To Shorter Shifts, Rebecca J. Arismendi

MSN Capstone Projects

Triage is a critical assessment process performed by a registered nurse by which Emergency Rooms (ERs) sort patients who present for a medical evaluation. With ER visits increasing, pressure on staff to move patients through the department is often palpable. Whether a patient decides to walk in, or come in by ambulance, the first person to assess the patient is the triage nurse. They determine the appropriate level of care needed for the presenting complaint.

After a review of literature, it was found that fatigue is correlated with shift length in triage with the highest level of fatigue being at …

Implementation Of Purposeful Hourly Rounding To Decrease Fall Rates, Dannette Kizy

Student Scholarly Projects

Practice Problem: Patient falls can lead to an increased length of stay and potentially reduce the quality of life. In addition to serious injury, the patient and the hospital have a significant financial burden. PICOT: On a medical-surgical unit, does incorporating purposeful hourly rounding in the patient care routine compared to no purposeful rounding decrease patient fall rates over eight weeks?

Evidence: Of the 35 articles related to fall prevention and PHR, a final selection of eight articles met the criteria and were of high quality and evidence levels.

Intervention: PHR was implemented to decrease falls over …

The Implementation Of A Nurse Residency Program, Jessica Conrad

MSN Capstone Projects

Implementing a nurse residency program in a hospital can be a successful plan to improve nurse retention and the quality of patient care. Nurse residency programs allow new graduate nurses to transition into professional practice and gain skills for safe and effective care. Components of the programs include preceptorship, educational seminars, shadowing days, and support from preceptors, educators, and other leadership members. The program also may provide benefits to hospitals, including improved patient outcomes, nurse job satisfaction, and decreased costs associated with reduced turnover. Successful implementation needs leadership, collaboration, and communication among all stakeholders, including the staff nurses, preceptors, educators, …

The Introduction Of A Family Advisory Council In A Neonatal Icu, Jennifer Streelman

MSN Capstone Projects

Having a baby can be a beautiful thing, but sometimes it’s not all sunshine and roses. Birth sometimes does not go smoothly, and sometimes it happens way too soon. The babies that need help at birth all end up in the neonatal ICU requiring differing levels of care. This is never what anyone plans, and therefore can cause lots of stress to new parents trying to navigate not only being new parents, but suddenly thrust into a world of medical uncertainty. Creating an environment that focuses on family centered care is vital to healthy role transition. The presence of a …

Peer-Supervision Of Nursing Professionals: A Shield Against Burnout, Kyle Gamache, Sarah Gamache, Joseph Robillard

Journal of Wellness

Introduction: Burnout is a major risk in healthcare professions and is a significant contributor to the current nursing shortage. Strategies to combat burnout of healthcare professionals are in desperate need. The purpose of this project is to introduce the clinical peer supervision model as a method to alleviate burnout in nursing professionals.

Approach: Eight nurses from in-patient settings participated in a peer-supervision support group, modeled after existing European nursing and mental health provider-support protocols. To assess the effect of this intervention, qualitative data analysis was conducted on the transcripts of session and the results described. All participants reported statistically high …

Leadership, Policy Development And Emr Utilization In At Services At Heidelberg University, Matallyn Overmyer

Masters Theses/Capstone Projects

The practicum is being completed with Heidelberg University AT Services. I started January 2023 and plan to finish April 2023. I am working directly with Tyson Depinet, Coordinator of AT Services, to learn more about roles and responsibilities of a collegiate head athletic trainer. Emphasized areas of focus: - EMR Administrative Utilization - Policy Development - Leadership & Managemen

Enhanced Discharge Preparation To Decrease Discharge Delays: A Quality Improvement Project, Angela Graham

Graduate Theses, Dissertations, and Capstones

Increased length of stay (LOS) is a focus in hospitals as it has implications for decreased quality of care, increased cost of care, and results in care delays for other patients (Rojas-Garcia et al., 2018). LOS is a measure of a hospital’s efficiency and throughput, which is the process of admitting, treating, and discharging patients. Micallef et al. (2020) found a longer LOS can occur from having extra days due to inefficiency in delivering care or from delays in discharge once the patient no longer needs acute care. The longer a patient stays in the hospital, the greater the risk …

Formal Unit-Based Shared Governance To Improve Nurse Engagement, Tracey A Larsen

Student Scholarly Projects

Practice Problem: Nurse engagement is a key driver of nurse satisfaction and nursing retention. Shared governance is an evidence-based practice proven to increase nurse engagement through shared decision-making and results in higher work satisfaction.

PICOT: The PICOT question that guided this project was (P) in an ambulatory nursing clinic (I) what is the effect of a shared governance unit-based committee (C) compared to current practice (O) on nurse engagement (T) over 10 weeks?

Evidence: An exhaustive literature search resulted in 61 peer-reviewed articles. Eleven studies were included after filtering for duplicates and keywords and evaluating for strength and quality …

Effects Of An Evidence-Based Practice Bundle Project On Nurse Empowerment, Kevin Jay Inman

Graduate Theses, Dissertations, and Capstones

The project determined the effect of an Evidence-Based Practice bundle program on nurses’ perception of empowerment. The EBP bundle included 7 interventions implemented simultaneously throughout a small community hospital. There was a significant increase in nurses’ perception of empowerment (p<.001), EBP beliefs (p<.001), and use of EBP (p<.001) after the implementation of an EBP bundle.

Implementation Of A Hospital-Wide Surge Plan To Reduce Emergency Department Length Of Stay, Laura Massey

Student Scholarly Projects

Practice Problem: Suboptimal patient flow throughout the hospital has resulted in an increased length of stay (LOS) for emergency department patients and the potential for adverse events.

PICOT: In admitted and discharged emergency room patients (P), how does a hospital-wide surge plan (I) compared to current throughput plan (C) affect the length of stay (O) within 8 weeks?

Evidence: The literature evidence reviewed supported the implementation of a hospital-wide surge plan approach positively impacts the emergency room length of stay and patient outcomes.

Intervention: The primary intervention for this project was the implementation of a hospital-wide surge policy. Targeted …

The Lived Experiences Of Icu, Med-Surg, And Er Nurses In The United States Attempting To Breastfeed During The Covid-19 Pandemic, Amy Seay

Dissertations

Breastfeeding is important to promote the health of both mothers and babies (Centers for Disease Control and Prevention [CDC], 2021). Many mothers experience workplace barriers and stress which negatively impact breastfeeding duration (McCardel & Padilla, 2020; Nagel et al., 2022). However, a gap in the literature exists surrounding specific barriers and the impact of stress on U.S. nurses who breastfeed. Specifically, workplace challenges and stress among nurses resulting from the COVID-19 pandemic lack exploration.

This interpretive phenomenological study explored the lived experiences of ICU, Med-Surg, and ER nurses who attempted to breastfeed during the COVID-19 pandemic. Roy’s adaptation model was …

Nursing Faculty Perceptions Of Stress, Coping, And Intent To Leave The Profession In The Ongoing Covid-19 Pandemic: A Quantitative Study, Lynlee Morgan

Dissertations

The COVID-19 pandemic impacted all of society to varying degrees; this impact was especially true in higher education due to an overnight transition to distance learning and incessant pivots to meet new guidelines and overcome obstacles. Nursing faculty were significantly impacted due to the responsibility of producing safe, qualified, competent practitioners to provide care in the clinical setting. The limitations in or exclusions from clinical experiences combined with the fact that faculty were managing personal concerns and had never encountered these unprecedented conditions exacerbated the challenge of preparing new nurses. This study was critical due to the faculty role and …

A Pilot Program To Address Nurse Leader Moral Distress Secondary To The Performance Evaluation Of Underperforming Personnel, Lisa Krening

Doctor of Nursing Practice Projects

Problem Description: First defined in 1984, as a nurse knowing the correct course of action but perceiving barriers that constrain the action, moral distress has evolved to include challenging situations associated with moral uncertainty, moral conflict, and ethical or moral dilemmas (Campbell et al., 2016; Fourie, 2015, 2016; Jameton, 1984). While the bulk of the moral distress literature has highlighted the challenges of direct care nurses, nurse leaders also grapple with ethical dilemmas that often lead to moral distress (Edmonson, 2010; Ganz et al., 2015; Prestia et al., 2017). Additionally, research indicates that nurse leaders lack experience in navigating ethical …

Orientation Materials: Impact Of Transitioning From Paper To An Electronic Format, Megan Bowles, Abby Lust, Teresa Rangel, Tobi Bryan

Articles, Abstracts, and Reports

Background:

In one region including 4 hospitals, acute care nurses historically met with professional development practitioners (PDP) and received binders containing printed, specialty-specific policies and a competency checklist (required to be signed and returned to the nurse leader) upon new hire or transfer. Creating physical orientation packets is costly, time-consuming, and restricts the ability to share appropriate orientation materials in the event of a PDP sick call. Real-time communication between the orientee, preceptor, PDP, and nurse leader regarding status of the competency checklist cannot occur with a physical binder. Providing electronic onboarding materials is a potential solution.



Purpose:

To describe …

Dnp Final Report: Conquering Rn Turnover: Implementing Flexible Scheduling To Improve Job Satisfaction, Camille Y. Parsee

DNP Final Reports

Nurse turnover is a complex problem for the nursing profession, especially in the behavioral health setting, where turnover rates are higher than the overall RN national average. The consequences of high nurse turnover include increased health costs, low-quality patient care, and staffing constraints. The association between nurse turnover and job satisfaction is profound because of their reciprocal relationship; therefore, implementing an intervention to help mitigate nurse dissatisfaction is essential to overcoming nurse turnover. Flexible scheduling is an intervention that gives nurses independence with their schedule which improves work-life balance and promotes nurse retention (Wright, 2017). The following PICOT question was …

Implementation Of A Daily Central Line Maintenance Audit Form In An Outpatient Infusion Center: A Quality Improvement Project, Sarah E. Christiana

DNP Projects

Significance and Background: Best evidence supports central venous access device (CVAD) dressing changes occur every 7 days or sooner, if indicated. At a community hospital in New England, patients receive outpatient antimicrobial therapy via CVADs. It is vital that nurses adequately maintain CVAD dressings according to evidence-based protocols to reduce the risk of central line-associated bloodstream infection (CLABSI). CLABSIs, associated with increased morbidity, mortality, and health care costs, are largely preventable through proper CVAD maintenance. At the project site, a review identified that dressing changes were frequently changed beyond the 7-day parameter. Documentation and surveillance processes were identified as opportunities …

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

Crna Decision-Making Within The Anesthesia Care Team, Cindi L. Dabney

Theses and Dissertations (ETD)

This research focused on Certified Registered Nurse Anesthesiologists’ (CRNAs’) perspectives on the value placed on their decision-making skills within the Anesthesia Care Team (ACT). The emphasis of the study was to examine CRNA’s perspectives on the strengths, challenges, conflict resolutions, and any other information they were willing to divulge when working with physician anesthesiologists in the ACT model. An electronic survey questionnaire was sent to practicing CRNAs, primarily in the southeast region of the United States, with 171 informants completing the questionnaire. Data analysis included demographic information of the convenience sample that included age, gender, initial educational preparation as a …

Benefits And Challenges Of Charge Nurses Taking Patient Assignments, Alyssa Kuhl, Jenna Thomas, Karlee Meadows

Scholars Week

No abstract provided.

Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment

Faculty Publications

The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.

Clinical Nurse Specialists: A Rare Breed, Teresa Jahn, Evalyn Michira, Elizabeth Plante

Nursing Posters

What is a CNS?:

• A clinical nurse specialist (CNS) is an advanced practice registered nurse (APRN) with graduate level education in nursing.
• CNSs are prepared to provided leadership, consultation, and clinical expertise for patients and their families, nurses, and systems.
• Have the autonomy to diagnose and treat based on advanced clinical assessment like other APRNs (Nurse practitioners, certified nurse midwives, certified registered nurse anesthetists).
• CNS work in all areas of healthcare like clinics, emergency departments, hospital units, entire healthcare systems, or even as independent practitioners/contractors.

Examining The Impact Of De-Escalation Training Among Emergency Department Nurses, Jonathan Recchi, Jeffrey N. Doucette, Janice E. Hawkins

College of Health Sciences Posters

Workplace violence is a growing concern for US nurses, especially in the context of COVID-19 and patient incivility. De-escalation training can help mitigate high-risk incidents, but its psychological benefits are not well understood. This study aimed to determine if de-escalation training for emergency department nurses provided psychological benefit. This pre-experimental pre-test, post-test study evaluated nurse confidence in coping with patient aggression, caregiver resiliency, professional quality of life, and intention to stay with the organization. Participants completed a pretest survey, attended a two-hour verbal de-escalation training via zoom, and then completed the posttest survey. The study showed that attending the two-hour …

The Use Of Non-Icu Confusion Assessment Method (Cam) For Delirium Management, Stephanie Barendt, John Sharon Hudson

College of Health Sciences Posters

The purpose of this study was to determine the effect the use of the non-intensive care unit confusion assessment method (non-ICU CAM) as an early screening tool for delirium would have on the nursing practice of medical surgical nurses. This quasi-experimental study focused on early screening and prevention training of inpatient nurses caring for adult inpatients to proactively reduce episodes of delirium. The training included an educational video on how to perform the non-ICU CAM assessment, 4 scenarios to test knowledge on scoring patient, and techniques for reducing delirium if patient is positive. After one month of multimodal training for …

Nurse Leader Burnout: A Pre-Survey/Post-Survey Quality Improvement Project, Shannon Martinez

Regis University Student Publications (comprehensive collection)

Title of the Project: Nurse Leader Burnout: A Pre-Survey/Post-Survey Quality Improvement Project

Objective/Purpose of the project: The objective of the project was to provide time for inpatient nurse leaders to take time to visit the resiliency room and or cart. The purpose of the study is to determine if scheduled use of the resiliency room and or cart can help improve nurse leaders’ ability to clear their mind and decrease burnout. Methods: Sample size of 17 inpatient nurse leaders at Sky Ridge Medical center were sent via Survey Monkey, a pre-survey using the Occupational Fatigue Recovery scale (OFERs). After …

อนาคตภาพการบริหารจัดการองค์การพยาบาล โรงพยาบาลสังกัดกองทัพอากาศ ช่วงพุทธศักราช 2570-2574, ศิริณา กมณฑลาภิเษก

Chulalongkorn University Theses and Dissertations (Chula ETD)

การวิจัยครั้งนี้มีวัตถุประสงค์เพื่อศึกษาอนาคตภาพการบริหารจัดการองค์การพยาบาล โรงพยาบาลสังกัดกองทัพอากาศ ช่วงพุทธศักราช 2570-2574 โดยใช้เทคนิคการวิจัยแบบเดลฟาย ผู้ให้ข้อมูลคือผู้เชี่ยวชาญเกี่ยวกับการบริหารจัดการองค์การพยาบาล โรงพยาบาลสังกัดกองทัพอากาศ จำนวน 18 คน วิธีการดำเนินการวิจัยประกอบด้วย 3 รอบ คือ รอบที่ 1 สัมภาษณ์ความคิดเห็นของผู้เชี่ยวชาญเกี่ยวกับอนาคตภาพการบริหารจัดการองค์การพยาบาล โรงพยาบาลสังกัดกองทัพอากาศ ช่วงพุทธศักราช 2570-2574 รอบที่ 2 นำข้อมูลที่ได้จากการสัมภาษณ์มาวิเคราะห์เนื้อหาแล้วสร้างแบบสอบถาม เพื่อให้ผู้เชี่ยวชาญแสดงประมาณค่าแนวโน้มความน่าจะเป็นในแต่ละข้อ และรอบที่ 3 นำข้อมูลที่ได้จากรอบ 2 มาคำนวณหาค่ามัธยฐาน ค่าพิสัยระหว่างควอไทล์ และจัดทำแบบสอบถามให้ผู้เชี่ยวชาญยืนยันความคิดเห็น เพื่อสรุปเป็นอนาคตภาพการบริหารจัดการองค์การพยาบาล โรงพยาบาลสังกัดกองทัพอากาศ ช่วงพุทธศักราช 2570-2574 ผลการวิจัยพบว่า อนาคตภาพการบริหารจัดการองค์การพยาบาล โรงพยาบาลสังกัดกองทัพอากาศ ช่วงพุทธศักราช 2570-2574 ประกอบด้วย 7 ด้าน ดังนี้ 1) ด้านวางแผนการบริหารองค์การ ได้แก่ การวิเคราะห์ภาระงานยุทธการด้านการแพทย์ทหาร 2) ด้านรูปแบบการบริการพยาบาล ได้แก่ การให้บริการเชิงรุกแก่ข้าราชการและครอบครัว รวมถึงผู้ทำการในอากาศ 3) ด้านการจัดการความรู้และเทคโนโลยีสารสนเทศ ได้แก่ การนำเทคโนโลยีสารสนเทศมาใช้ในการบริหารจัดการ 4) ด้านนวัตกรรมและการพัฒนางานคุณภาพ ได้แก่ การยกระดับความสำเร็จในการผลิตผลงานวิจัย นวัตกรรมทางการพยาบาลและงานพัฒนาคุณภาพ 5) ด้านการจัดการทรัพยากรมนุษย์ ได้แก่ การพัฒนาทักษะที่จำเป็นให้กับบุคลากรพยาบาลอย่างต่อเนื่อง 6) ด้านสนับสนุนการจัดการศึกษา ได้แก่ การพัฒนาหลักสูตรพยาบาลศาสตรบัณฑิตให้มีคุณลักษณะและสมรรถนะเชิงวิชาชีพเป็นไปตามความต้องการขององค์การพยาบาล และ 7) ด้านการเตรียมพร้อมรับภารกิจด้านการแพทย์ทหาร สถานการณ์ฉุกเฉินและการบรรเทาสาธารณภัย ได้แก่ การพัฒนาศักยภาพของบุคลากรพยาบาลด้านการปฏิบัติการแพทย์ฉุกเฉิน

Accreditation Commission For Education In Nursing (Acen): A Mixed Methods Study To Determine Accreditation Readiness At A Non-Profit Organization Located In Western North Carolina, Leslie Queen

Doctor of Education Dissertations

The accreditation process allows programs to complete the reflection process of program evaluation, where they assess and measure themselves via preset standards and suggested outcomes. The theoretical framework of Getzels and Guba (1957) was used to determine if the people within the nonprofit organization studied could successfully fulfill the predetermined expectations of the organization. This study also examined the value of program evaluation, explained the process used by schools of nursing that wish to seek national accreditation, investigated the benefits and strengths of attaining accreditation, and uncovered possible barriers that may hinder accreditation efforts. By exploring these topics, conclusions were …

Polypharmacy: Increasing Medication Adherence, James C. Kelly

Nursing | Student Research Posters

Polypharmacy is a common problem among older adults where they take multiple medications concurrently, leading to negative health outcomes such as adverse drug reactions, drug-drug interactions, and non-adherence to medications. To address this issue, a randomized controlled trial (RCT) is proposed that will involve elderly patients (aged 65 years or older) who are taking five or more medications. Participants will be randomly assigned to either the intervention or control group, with the intervention group receiving nurse-led medication therapy management (MTM) and patient education to improve medication adherence. The Health Belief Model can be used to educate and empower older adults …