Other Nursing Commons^™

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

Debriefing With Pearls & Watson’S Caritas, Heather A. Uccello

Seton Hall University Dissertations and Theses (ETDs)

Debriefing, an important aspect of students’ clinical experience, is a reflective, critical thinking analysis and communication strategy that provides rapid feedback after either a simulated or genuine clinical event. To teach this higher-level critical thinking skill throughout the learning process, nursing programs require specific methodology and faculty expertise. The National League for Nursing supports nurse educators having a theory-based strategy, formal training, and ongoing competency evaluation. Informed by Jean Watson’s Theory and the Promoting Excellence and Reflective Learning in Simulation standardized debriefing tool methodology, this project outlines a framework that nursing schools can use to potentially improve the debriefing process …

Standardized Education On Physician Orders For Life Sustaining Treatment (Polst) Conversations, Venessa Oteniya

Doctor of Nursing Practice Final Manuscripts

According to research literature, 15% of Medicare beneficiaries spend more than 7 days in the intensive care unit before they die. These Medicare beneficiaries receive aggressive, life-prolonging medical treatments that might not be in agreement with their wishes. Approximately 13% of SNF residents have improperly completed POLST forms that can result in intensive treatments that patients did not want. One barrier to the lack of POLST completion in SNFs is staff difficulty with understanding and explaining the form, a result of inadequate education.

In August 2020, the San Diego Coalition for Compassionate Care formed an education program to provide virtual …

Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson

Doctor of Nursing Practice Scholarly Project

The purpose of this study is to identify what types of disruptive behavior nurses are experiencing, discuss outcomes of disruptive behavior, and educate healthcare providers and administrators of disruptive communication. Understanding the consequences of disruptive communication can help educators articulate the need for training in conflict management and therapeutic communication methods. It can also aid healthcare providers to be more conscious of their behavior in the professional setting. Seven research questions related to communication were developed and analyzed in this study. The author developed a pre-education survey that included demographics, multiple-choice questions, and open-ended questions to assess the nurses' knowledge …

Development And Implementation Of Computer-Based Learning Modules On Alternative Communication For Pediatric Nurses And Nursing Students, Amanda Kaye Simmons

Theses and Dissertations (ETD)

Purpose and Rationale. To develop, implement, and assess computer-based learning modules (CBLs) on augmentative and alternative communication (AAC) with pediatric nurses and nursing students for knowledge outcomes, self-efficacy, and perceived relevance and effectiveness. Effective communication ensures all parties can understand and express themselves clearly, through any means necessary, often including AAC tools, supports, and strategies. Communication is essential in healthcare but there is limited research with pediatric nurses. Previous research with a single hospital indicated a need for nurse education on AAC. This research used focus groups and interviews to understand pediatric nurse and nursing student knowledge about AAC. The …

Discharge Instructions In The Emergency Department, Josh Jorgensen

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.

Social Media And Mental Health In Adolescents And Young Adults: A Systematic Review, Dawn Ritter, Kimberly Ray, Celia Keefe

Williams Honors College, Honors Research Projects

The goal of our project is to increase understanding of the link between social media use and mental illness in teens and young adults. Our objective is to write a systematic review of the literature to answer the PICOT questions: (1) In teens and adults, younger than 25 years, what is the relationship between social media use and mental illness? (2) In teens and adults, younger than 25 years, what is the effect of interventions, such as social media as a resource, on mental health promotion and well-being? The motivation for our project comes from the increased use of social …

Introducing A New 12 Week Education & Simulation Program To Optimize Financial Performance Of Nurse Managers, Melissa Hathcoat

Master's Projects and Capstones

Problem: Several nurse executives (Waxman 2018; Massarweh, 2017; Hunt, 2018) agree that in today's increasingly complex health care environment, the reality of decreasing reimbursements and increasing focus on value-based metrics reflects a crucial knowledge base for nurse managers. Therefore, it is imperative for unit-based nurse leaders to receive education and support to attain and maintain the requisite business competencies to achieve both fiscal and quality targets in their microsystem (McFarlan, 2020). In an integrated managed care delivery system in northern California, no education curriculum exists for nurse managers and assistant nurse managers that addresses gaps in financial knowledge, skills, and …

Increasing Nurse Knowledge Using A Formal Lung Transplant Education Program, Amy M. Stoddard, Donna Lynch-Smith, Kate Carlson Wrammert, Bobby Bellflower

Doctor of Nursing Practice Projects

This quality improvement project was completed to show that a formal lung transplant education course for nurses caring for lung transplant patients increased their knowledge. An eight-hour education course was developed by experts in the field of lung transplantation. A pretest was administered before the education course. A posttest was administered to determine if knowledge was improved. A three-month follow-up test was administered to determine knowledge retention. Based on the data analysis, nurse knowledge improved after formal education. Item analysis determined what areas of educational content need to be the focus of quarterly education. The education course was adopted as …

Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman

Doctoral Projects

Endotracheal intubation is an essential component within the skill set of anesthesia providers. Rapid arterial desaturation remains a primary risk factor during laryngoscopy and intubation. The risk for hypoxemia exists because during endotracheal intubation, patients are apneic or hypo-ventilating (Wong et al., 2017). Apneic oxygenation (AO) has been advocated to attenuate hypoxemia during endotracheal intubation (Pavlov et al., 2017).

The aim of this project was to assess for any knowledge deficits regarding AO among anesthesia providers and assess the willingness of these providers to include AO into their current practice. The project investigator conducted an education session involving the …

The Effects Of Moderate-Severe Plaque Psoriasis On Patient Well-Being And Prevention Of Flares, Glenn Devera

Nursing | Senior Theses

Psoriasis is a chronic skin condition that is indicated by red, patchy and scaly skin that can be painful when irritated. Patients with psoriasis have an increased risk for a number of chronic diseases. Despite the expansion of treatments for moderate-to-severe psoriasis over the last decade, patients may still find that treatment strategies are not as successful, leaving them dissatisfied with their treatments. A relationship built upon trust between the nurse and the patient diagnosed with psoriasis may serve to help ensure optimal care. A comprehensive literature review was performed and found that best practices for patient management need to …

Peripheral Iv Bundle, Alicia Hanna

Graduate Theses, Dissertations, and Capstones

Abstract

It is estimated that over 90% of hospitalized patients require IV access during their hospitalization. Peripheral IVs (PIVs), while less risky than central lines, are not without risk to the patients. Intravenous (IV) infiltration in pediatric patients is a very common complication associated with IV access, accounting for about 67% of IV catheter removals; a less common complication, but much more serious complication of a PIV can be a blood stream infection (BSI) which can account for up to 35% of BSIs seen in patients. BSIs are associated with increased length of stay, increased morbidity and can result in …

Communicating Confidently: Skills For Nursing Student Clinical Success, Cari Granier

Journal of Interprofessional Practice and Collaboration

Background: Ineffective communication in healthcare has been tied to medical errors and provider stress (Chaharsoughi et al., 2014). Many nursing students struggle when communicating in the clinical setting because they lack confidence. When left unaddressed, this issue can follow students as they begin their nursing careers. Purpose: The study focused on measuring how confident undergraduate nursing students felt communicating with patients, visitors, nurses, and faculty in the clinical setting prior to and after instructor-led interventions. Methods: 17 first-year baccalaureate nursing students from Nicholls State University volunteered to participate. Participants were asked to anonymously complete a survey prior …

Factors Predicting Sustainability: A Correlational Study Of One Multi-Site Program, Meredith L. King Jensen

Dissertations, Theses, and Capstone Projects

Healthcare organizations invest significant economic, physical, and human resources to implement changes and expect sustained benefits for their investments in the long term. Yet, few studies have examined long-term sustainability and factors contributingto sustainability. The primary aim of the study was to gain a better understanding of sustainability and five factors (champions, leadership support, policy, resources, and training and education) that might predict long-term sustainability within the context of one Safe Patient Handling and Mobility (SPHM) program implemented in a large, nationwide system more than 7 years ago. The secondary aim was to examine the number of nursing staff injuries, …

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so that care …

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Denise Harbaugh, Diane Whitehead

Walden Faculty and Staff Publications

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …

Development And Validation Of A Scale To Measure Nurse/Medical Resident Physician Collaboration, Bruce St. Amour, W. Brady Dehart

HCA Healthcare Journal of Medicine

Introduction: The purpose of this pilot study is to investigate the reliability of an interprofessional collaboration measurement scale used for nursing interactions with resident physicians. To date, the collaboration between nurses and residents has not been adequately investigated and a validated tool specifically for this purpose is not yet available. Our objective is to adapt a previously validated interprofessional scale for health care settings to the specific nurse/resident physician collaboration.

Methods: In 2019, nurses from two hospitals were contacted via email and were invited to complete an anonymous survey that asked about the nurses’ interaction and collaboration with resident physicians. …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

The Influence Of End Of Life Education On Stress, Anxiety, And Attitude Of The Healthcare Profession Student, Chiquesha Davis

DNP Final Reports

Providing comfort and support to the dying patient is a significant part of the dying process. When soothing a patient, who is dying, the goal is to prevent or relieve suffering as much as possible. Respecting the patient's health and quality of life goals and decisions is essential. Healthcare profession students can experience multiple levels of anxiety, stress, and a negative attitude while taking care of the dying patient. The implementation of a successful intervention is at the cornerstone of helping reduce stress, anxiety, and attitude change in healthcare profession students. The application can also have a positive impact on …

Pilot Project: Developing A Standardized Evidence-Based Education Process For Nurses To Enhance New Medication Eduction Of Hospitalized Patients With Heart Failure, Michele Ann Crotteau

Doctor of Nursing Practice Projects

Problem Description: Research has shown that health information is difficult for the average adult to understand while clear communication helps patients feel involved and increases adherence to treatment. The Joint Commission recommends Health Literacy (HL) assessment and the use of the Teach Back Method (TBM). Medication errors that occur between the RN and elderly patient are preventable when the RN communicates effectively about the patient’s medications. A paucity of research exists evaluating TBM for nurse-patient communications. This Quality Improvement (QI) Pilot Project (PP) took place over 3-months, aimed to improve new medication education to elderly patients with Heart Failure (HF). …

Utilization Of A Concurrent Query Form To Improve Clinical Documentation In A Va Facility For Patients With Stroke Or Tia, Lisa A. Keefner

Electronic Theses and Dissertations

Caring for stroke patients diagnosed with acute ischemic stroke (AIS) and transient ischemic attack (TIA) at Veterans Health Administration (VHA) acute care hospitals is a very complex process that centers on accurate documentation. Inaccurate or missing documentation leads to patient safety issues, lower quality care, and inaccurate Veteran Equitable Resource Allocation (VERA) classification for reimbursement. This pilot project’s 3 problems of interest include improving provider response to clinical queries about documentation, capturing national metrics collected by the VHA, and accurately representing veterans in VERA classification. Based on a review of the literature available on patient treatment file (PTF) accuracy and …

Student Experiences With Engagement In A Nursing And Physical Therapy Interprofessional Education Simulation, Sarah Koplow, Melissa Morris, Shari Rone-Adams, Heather Hettrick, Bini Litwin, Lisa B. Soontupe, Archana Vatwani

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional Education (IPE) incorporated into healthcare discipline instruction has been shown to be successful in improving the understanding perceptions of complimentary professions. The purpose of this mixed method study was to measure differences in perceptions of early Baccalaureate of Science in Nursing (BSN) students and Doctor of Physical Therapy (DPT) with participation in a immersive interprofessional education experience. Method: Students completed a pre and posttest survey consisting of the Readiness for Interprofessional Learning Scale and several short answer qualitative questions. Cohorts of BSN and DPT students participated in a computerized mannequin simulation experience or a hybrid simulation. Results: Students …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Improving Low Health Literacy In Poststroke Patients By Educating The Health Care Staff, Marthilde Brzycki

Electronic Theses and Dissertations

Abstract

Lack of health literacy in the poststroke patient population is a serious issue; with the addition of the homeless population to that group, the result may be devastating. According to the American Heart Association and American Stroke Association (AHA/ASA, 2016), stroke is considered the primary cause of death and one of the chief reasons for disability in the United States, and nearly75% of strokes occur in those who are 65 years of age or older. Nurse practitioners are vital, providing necessary training and stroke education to the nursing and other health care staff. This DNP project was initiated to …

Reducing Pressure Ulcers In Emergency Department Boarding Patients, Youa Yang

Nursing and Health Professions Faculty Research and Publications

CRMC is a level one trauma and teaching hospital in Fresno, California. CRMC’s emergency department (ED) is licensed for 84 beds. When hall beds are added this ED can go up to 110 beds. CRMC sees over 9,000 patients a month. Due to an increase in hospital census and length of stay, this ED has a daily average of 30 inpatients boarding. In December of 2018, this ED had one hospital acquired pressure ulcers (HAPU). Barriers to preventing HAPU’s in the ED are rooms that are not big enough to accommodate hospital beds, inexperienced new nurses who are unaware of …

Preparing Healthcare Staff For Cardiac Arrest Codes In The Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes, Rowan Edwards, Rn

Master's Projects and Capstones

Preparing Healthcare Staff for Cardiac Arrest Codes in the Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes

The acuity of care provided in outpatient clinical settings across the United States continues to rise. It is estimated that more than 350,000 cardiac arrests occur outside of a hospital each year (AHA, 2019). For the purpose of this clinical nurse leader (CNL)-lead quality improvement project, the relevant focus is directed towards improving the knowledge, physical skills and perceptions of healthcare staff within an urgent care center (UCC) regarding the application of advanced rescue skills. It is important to note that the …

Race-Based Trauma Care Training For Veteran’S Health Administration Nurse Practitioners, Vanessa Loyd

Dissertations

Abstract

Problem: Trauma informed care has become a priority for persons exposed to psychological, physiological, emotional consequences as a result of traumatic experiences. Veterans are from different cultures, including gender, race, religion, sexual orientation and other social groups. The Veterans Health Administration (VHA) is responsible for the health of this culturally diverse patient population. Healthcare providers without any prior military experience may experience difficulty obtaining an accurate history and physical exam due to the military’s cross-cultural environment. The project aim was to increase confidence and competence in race-based trauma care by incorporating training into a new acute care fellowship …

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

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. 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. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Fostering Meaning Making In Grieving Adults With Intellectual And Developmental Disabilities, Teresa Graziano

Senior Honors Projects

No abstract provided.