Nursing Administration Commons^™

Nurse Manager Perceptions Of Strategies To Overcome The Underutilization Of Nonpharmacological Pain Control Methods In Adult Acute Care, Landen M. Bonnell

Undergraduate Honors Theses

A basic patient right is to have pain adequately managed. However, research consistently indicates that many adult patients in acute care experience inadequately managed pain, which may contribute to adverse patient outcomes. Studies have shown that nonpharmacological pain management can lead to increased patient satisfaction, shorter hospital stays, and better patient outcomes. However, many barriers exist to nurses providing effective nonpharmacological pain control therapy, primarily including heavy workload and a lack of education and support. Currently, there is insufficient research on how to overcome these barriers. Four nurse managers with experience in nursing leadership were interviewed using a qualitative descriptive …

From Evidence To Practice: Improving Diabetic Patient Outcomes By Increasing Statin Utilization, Elizabeth Mcfalls

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) prevention in patients with diabetes is essential, as heart disease remains the leading cause of death within this population (American Diabetes Association, n.d.). The purpose of this evidence-based project is to improve patient outcomes by enhancing adherence to statin therapy. A thorough literature review yielded 246 pieces of moderate-to-high-quality evidence; of these, eight articles were appraised in detail and selected for project inclusion. The strongest evidence identified four meaningful interventions. Thus, a multimodal approach was indicated for this project. This included addressing barriers to therapy, creating practice nudges, implementing a shared decision-making (SDM) tool, and utilizing clinical …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

Discharge Process Improvement Initiative Using An N-By-T Strategy In A Progressive Care Unit In An Acute Care Setting, Sukhvir Walia

Doctor of Nursing Practice Projects

Background

Timely and efficient patient discharge processes are crucial for enhancing hospital throughput, reducing emergency department boarding, optimizing inpatient bed utilization, and ensuring safe transitions of care. Delayed hospital discharges contribute to prolonged hospitalizations, operational inefficiencies, increased healthcare expenditures, and decreased patient satisfaction. Progressive care units (PCU) are particularly vulnerable to discharge delays because patients frequently require multidisciplinary coordination before safe discharge can occur.

Purpose

The purpose of this quality improvement project was to evaluate the effectiveness of implementing a structured discharge readiness checklist combined with an n-by-T discharge planning strategy during multidisciplinary patient progressive rounds (PPRs) to improve discharge …

Voice Your Choice, Sarah Olson, Mercy Bustamante-Vizarretea, Hannah Bauman, Sally Hall

SPARK Symposium Presentations

Our proposal seeks to develop and implement a standardized Charge Nurse Interest Survey which will create a structured process for identifying those most interested and best suited for the position of charge for all registered nurses on a local med-surg unit. Nurses on this unit are appointed and eligible to serve in the charge nurse role after six months of experience on the unit. Research shows that charge nurses who demonstrate emotional stability, composure under pressure, strong organizational skills, and proactive planning contribute to improved team functioning and decreased workplace strain (Gottlieb & Gøtzsche-Astrup, 2018).

To clarify the charge nurse …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Improving Hospital Discharges Before Noon: Implementation Of A Vida (Very Important Discharge Appointment), Nadia Paul

Evidence-Based Practice Project Reports

Delays in hospital discharge can negatively affect hospital throughput and bed capacity, resulting in increased length of stay and boarding of patients in off-unit locations which causes concerns for patient safety and potential harm (Rutherford et al., 2017). The purpose of this DNP project was to determine if the implementation of a very important discharge appointment (VIDA) would increase the number of hospital discharges occurring before noon (DBN) each day. This project was implemented at a 350-bed academic medical center in East Central Indiana. A 25-bed, adult medical unit served as the pilot unit. In total, 538 patients were included …

Responsible Pain Management For Postpartum Patients, Anna Beth Wyatt, Isabella B. Conwell, Kaley E. Edelbrock, Missy M. Sterkel

SPARK Symposium Presentations

At Vanderbilt University Medical Center’s postpartum unit on 4 East, uncontrolled pain is a leading cause of decreased patient satisfaction and increased risk for complications. Effective, timely, and conscientious pain management plays a crucial role in improving patient satisfaction and promoting safer recoveries. Given the wide range of pain management needs due to varied birth experiences and complications, nursing judgment and clear patient communication are essential in ensuring both comfort and long-term safety. This makes 4 East an ideal unit to explore standardizing communication strategies to optimize patient care. The primary goal of our intervention is to enhance patient satisfaction …

Preventing Nurse Burnout In The Trauma Icu, Annelise Wilson, Samantha Pendleton, Hailey Dowd

SPARK Symposium Presentations

This change project identifies that nurse burnout is a prevalent problem within the healthcare setting, specifically with nurses working in a critical care environment. Burnout can be described as a negative outcome resulting in exhaustion (emotional, mental, physical) due to stress. The population focused on is the nursing staff on the trauma intensive care unit at VUMC. The proposed recommendation for change is to have a mandatory resource nurse on every shift. Essentially, this nurse is one who has no patients and can be utilized to fill in for breaks and perform anything under the nurse's scope of practice when …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

Clinical Learning Obstacles Of Nursing Students At The University Of Mosul: A Qualitative Study, Karam Yaseen Fathi, Younes K. Attia, Atheer Abd Ahmed, Ahmed K. Mohamed Taher

BioMed Visions Journal

Background: Clinical learning is a crucial component of nursing education, as it provides students with the opportunity to apply their theoretical knowledge in real-life healthcare settings. However, nursing students often face obstacles during their clinical experiences that can hinder their learning and professional development. The study aim to explore the obstacles that nursing students confront during clinical training.

Materials and Methods: A qualitative phenomenological study design was used to reach the study's aim. The study was conducted in Mosul city and included 20 nursing students who were selected purposefully. A semi-structured interview with open-ended questions was used to collect …

Assessing The Effectiveness Of A Non-Punitive Fall Prevention Program, Nicki Roderman, Shandlie Wilcox, Cynthia Lang

HCA Healthcare Journal of Medicine

Background

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results.

Methods

Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive …

The Future Of Nurse-Led Research: The Road Ahead, Sammie Mosier

HCA Healthcare Journal of Medicine

Nursing as a profession is full of innovation. From nurse-led research and new technology to emerging models of care, nurses continue to blaze trails and take steps to improve patient care. As one of the largest employers of nurses in the United States, HCA Healthcare has an obligation to produce research and evidence-based practices to pave the way for the future of nursing practice and potentially change how care is delivered. In this editorial, HCA Healthcare’s chief nurse officer describes her vision for the future of nurse-led research and examines how education, partnerships, and technology facilitate the road ahead for …

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

DNP Qualifying Manuscripts

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Dnp Final Report: Balancing Self-Care And Patient Care: An Intervention To Enhance Well-Being For Acute Care Nurses, Robert V. Rose Jr.

DNP Final Reports

This project delves into the profound impact of the COVID-19 pandemic on healthcare and nursing, focusing on the well-being of nurses within the context of acute care settings. Poor well-being leads to increased levels of burnout and the evidence-based practice project aimed to increase the perception of well-being.

The formulated PICOT question driving this project was: In acute care nurses (P), how does the use of Acceptance and Commitment Therapy (ACT) program (I) compared to no Acceptance and Commitment Therapy (ACT) (C) impact nurses’ perception of well-being (O). The evidence substantiates that ACT interventions effectively elevate perceptions of well-being, as …

Development And Evaluation Of Trauma Informed Care Education For Licensed Nurses, Kristina O'Meara

Epsilon Sigma at-Large Research Conference

Trauma informed care nursing education is crucial. Trauma informed care is a method of providing health care which understands the likelihood of past and present traumatic events in patients and families. The experience of past or present trauma often led to chronic diseases, substance abuse disorder, fragmented health care, fears surrounding health care, chronic stress, and other negative health consequences. The purpose of this project is to increase licensed nurses’ awareness and ability to practice trauma informed care in clinical practice, as well as promote policy initiation within the health care facilities. Method planning integrated the Knowledge to Action Cycle. …

Implementation Of A Healthy Skin Committee And Education On The Number Of Hospital Acquired Pressure Injuries, Laura Viana

SACAD: Scholarly Activities

Abstract

Over the years, hospital-acquired pressure injuries (HAPI) have emerged as a significant challenge in the healthcare industry. Despite significant advancements in healthcare, pressure injuries continue to be a persistent global healthcare issue, closely linked to the safety of patients, affecting patient outcomes, and increasing healthcare costs (Gaspar et al., 2019). HAPIs are associated with increased morbidity and mortality rates. HAPIs are likely to experience longer hospital stays, increased risk of infections, higher treatment costs, and potentially more significant health complications. HAPIs commonly occur in the hospitalized patient and are costly and preventable. Given the implications of HAPIs, there is …

Nursing Care During Natural Disasters, War Zones, And Mass Casualty Incidents: Implications For An Educational And Professional Overhaul, Erin N. White

Undergraduate Honors Theses

Emergency situations around the world are inevitable. Any nurse who practices for any period of time is sure to encounter situations like these. Their hospital may be flooded with traumatic and severely life-threatening patient cases where supplies can become scarce. In these situations, a nurse and all other healthcare personnel are expected to act effectively, efficiently and in a highly organized way. Despite this need, many hospitals fail to implement effective disaster preparedness programs and plans. This leaves healthcare workers at a loss for how to treat patients, communicate within and outside of the hospital, coordinate transport, and all the …

Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner

MSN Capstone Projects

Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …

The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins

MSN Capstone Projects

In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …

Improving Safety In The Emergency Department: Utilizing Metal Detectors To Mitigate Weapon Possession, Jonathan Garcia

MSN Capstone Projects

Today’s high risk-healthcare environment has prioritized patient safety with great initiatives and, unfortunately, placed staff safety second. However, safety for both groups should be equal priorities. Evidence suggests that Emergency Departments (ED) often care for patients with a history of crime and mental health diagnoses, creating an environment where the threat of violence and weapons is increasingly prevalent compared to other clinical settings. (Erlyana, 2019) Risk mitigation is possible if we consider studies by Malka et al. (2015) and Laidlaw et al. (2017) that indicate the efficacy of metal detectors in accurately identifying concealed weapons. To improve clinician and patient …

Shared Governance And Transition Into Practice: Impact On Work Engagement, Gudrun M. Reiter-Hiltebrand

Student Scholarly Projects

Practice Problem: High turnover rates, particularly in new graduate nurses, and poor organizational commitment and engagement negatively affect staffing, operational performance, and patient outcomes. A negative trend for nurse engagement indicators was noted in previous staff engagement surveys of this organization.

PICOT: The PICOT question that guided this project was: In transition-into-practice (TIP) nurses (P), how does the implementation of shared governance (I) compared with no shared governance participation (C), affect their engagement with the hospital (O) within eight weeks (T)?

Evidence: Literature has shown that nurse engagement is one of the nurse indicators positively affected by shared governance …

Factors Influencing High Nurse Turnover In A Midwestern U.S.A. Community Hospital And A Proposal For Change, Deborah Mokeira Omagwa

Doctor of Nursing Practice Projects

Nurse turnover has become a universal problem in recent years, causing nurses to bear the burden of higher patient loads, working overtime hours, and dealing with unfavorable working conditions. Nurses sometimes feel they have no voice to fight for them while they struggle at the bedside to improve patient outcomes. The purpose of this project was to be a voice for the nurses to inform the hospital administration on data driven results on how nurse turnover can be reduced, with the goal that the proposed nurse retention strategies will be implemented in this community hospital.

This was a qualitative project …

The Dedicated Education Unit: Increasing Capacity And Confidence, Heather Marie Van Housen

Doctor of Nursing Practice (DNP) Projects

Background: In the American Association of Colleges of Nursing (AACN) 2020 annual survey, nursing schools turned away 66,274 entry-level applications to baccalaureate nursing programs in the United States due to a faculty shortage and clinical placement sites (AACN, 2021).

Local Problem: Hospitals need more qualified nurses to meet community needs. The need for clinical faculty and additional clinical placement sites disrupts the workforce pipeline through local nursing schools. A new approach to clinical education is needed to prepare more students for the growing complexities of independent nursing practice.

Methods: Dedicated Education Unit (DEU) implementation to expand pre-licensure nursing student clinical …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

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, …

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 …