Dnp Final Report: Breaking The Cycle: Care Coordination Interventions And Sickle Cell Readmissions, Naphtali Edge

DNP Final Reports

Background

Approximately 100,000 people in the United States are affected by Sickle Cell Disease (SCD). Sickle Cell Disease represents the second highest readmitting diagnosis at Houston Methodist Hospital. The purpose of this study is to determine the impact of implementing care coordination interventions to reduce hospital readmissions of patients with SCD.

PICOT

In adult patients with SCD in the acute care hospital setting, how does care coordination intervention compared to no care coordination intervention affect the readmission rate for patients with SCD over a 3 – 6-month period?

Body of Evidence

Eleven studies were critical appraised and included in the …

Increased Discharge Compliance Through Mental Health Follow-Up, Robert H. Kirby

MSN Capstone Projects

Emergency departments are being strained to their breaking points as a result of the recent COVID pandemic. These departments are in need of programs that can help to reduce stress on not only limited budgets but also reduce the strain on their overwhelmed staff. One such strain on emergency departments and their limited resources is the readmittance of mental health patients as a result of non-compliance of the discharge instructions. The change project looks to address whether following up 10 days post discharge can increase discharge instruction compliance and ultimately reduce readmissions. The aim of the project is through the …

Comparison Of Education Styles For Nursing Students: Team-Based Learning Versus Traditional Lecture, Hannah Gean

MSN Capstone Projects

Nursing graduates are coming into the workforce still lacking in important areas. Nurses need to have cultivated leadership, communication, and satisfaction skills before they start their first job. For this to occur, nursing students need to be prepared with these qualities while they are still in school. It is important for students to not only learn healthcare knowledge but to have practical skills in a variety of areas. When students learn through the traditional lecture method, it is not always possible to assess and support their learning in leadership, communication, and satisfaction. To ensure that students are receiving these values …

The Relationship Between Early Discharge Planning And Length Of Stay, Kandiss Hearn

MSN Capstone Projects

Discharge planning (DCP) and early discharge intervention has proven to have a direct effect on reducing hospital length of stay (LOS), reducing readmissions, reducing patient morbidity, improving patient satisfaction and possibly reducing patient healthcare cost. This proposal specifically addresses hospital length of stay but with research it was found that early DCP also has the potential to improve outcomes in several areas adjacent to both the patient aspect and business aspect of health care. The proposed question is as follows: In adult hospitalized patients (P), how does discharge planning within the first 24 hours of admission (I) compared to late …

Huddle And Safety, Jaelynn Hall Bsn, Rn

MSN Capstone Projects

The purposed evidence-based practice (EBP) project focuses on a nursing intervention (team huddles) to increase safety and reduce inpatient fall rates. Negative outcomes to consider from an inpatient fall are harm and injury to the patient along with increased health care cost for the patient as well as hospital facility. Accrued cost associated with an in-patient injury resulting from a fall is not reimbursed according to the Centers for Medicare and Medicaid Services. The additional cost for hospital-acquired falls is estimated to be $6,694 (95% CI: -$1,277 to $14,665) (Agency for Healthcare Research and Quality, 2017). This was only related …

Oncology Nurse Compassion Fatigue Benchmark Project, Jessica R. Hayward

MSN Capstone Projects

Oncology nurses provide care to patients during some of the toughest times in their lives. This care places nurses at risk of developing compassion fatigue which can have negative long-term health impacts. There is currently no formal compassion fatigue education offered to oncology nurses. This lack of training leaves nurses vulnerable to the impacts of unmanaged stress, burnout, and compassion fatigue. This benchmark project was completed to bring awareness to the need for a mindfulness-based compassion fatigue course. This course will provide oncology nurses with the knowledge and skills necessary to manage these difficult emotions.

Patient Controlled Fluid Restriction Monitoring, Christina Tindel

MSN Capstone Projects

Patients are often placed under non-pharmacologic orders such as fluid restrictions during their hospital stay. The following article will discuss a plan to implement a change to have patients take a more active role in their plan of care by being the main ones to monitor their fluid intake.

Motivators And Barriers Associated With Intent To Complete A Bsn For Hispanic Associate Degree Nurses, Marissa Jimenez

Nursing Theses and Dissertations

Hispanics who are registered nurses (RNs) are more likely to enter the nursing profession through an associate degree nursing program and are less likely than any other racial/ethnic groups to complete advanced degrees. The purpose of this study is to explain the relationship between motivators and barriers associated with the intent to complete a bachelor’s degree in nursing (BSN) for Hispanic associate degree nurses (ADNs). The research question for this study was, “how much variance in intent to complete a BSN do Hispanic associate degree nurses attribute to motivators and barriers to returning to school for RN to BSN?”

Ajzen’s …

Nurse Practitioner Occupational Burnout: A Focus On The Variables And Themes, Tanya G. Schlemmer

Nursing Faculty Publications and Presentations

Purpose: The prevalence of occupational burnout is high amongst service professionals and the nursing profession is no different. The rate of occupational burnout amongst nursing professionals and medical professionals is high. The themes or impact of occupational burnout amongst Nurse Practitioners is not well described in the literature. Herein this article describes the investigation into the issue of nurse practitioners and occupational burnout.

Data Sources: Scientific literature review, CINHAHL Complete and other online literature databases and resources. A State of the Science systematic review was conducted to further examine this issue to identify the prevalence of the problem amongst nurse …

Dnp Final Project: Implementing Teamstepps Training: Using Evidence To Impact Teamwork In An Acute Care Hospital, Nana Baah Adjei

DNP Final Reports

Background: Medical errors are the third leading cause of death in the United States. Patient morbidity and mortality will decrease when institutional efforts result in the implementation of action plans which reduce medical errors. Teamwork, education, and training through structured initiatives are the most effective mechanism to improve patient safety. Purpose: The project aims to impact the perception of communication among newly hired medical surgical nursing and support staff. The acute care hospital is a 200-bed tertiary care hospital. Intervention: The intervention consists of the registered nurses and support staff participating in an innovative, six-hour, interactive TeamSTEPPS fundamentals course. Results: …

Improving Caregiver Health Literacy Of Pediatric Febrile Illness: A Patient Care Initiative, Rebecca T. Shipley

DNP Final Reports

Background: Pediatric fever, though typically harmless and incredibly common, can cause substantial fear and anxiety for caregivers unfamiliar with how to manage or treat this condition at home. Studies evaluating pediatric emergency department (ED) rates have repeatedly found fever to be a leading reason for clinical evaluation. Local EDs record percentages as high as 40% of pediatric patients seek evaluation primarily for fever. Purpose: Provide educational resources for high-risk populations to reference at home regarding fever so that avoidable ED visits decreased and caregiver knowledge of fever improved. Methods: An educational program was implemented at a pediatric primary care clinic …

Official Mentor Program Benchmark Project, Gabriela O'Hara

MSN Capstone Projects

Nursing shortage, turnover, and low job satisfaction are constant issues that often trouble healthcare organizations. These issues have led organizations to implement programs, such as externship, internship, and preceptor programs to strengthen new nurses’ professional practice and skills. However, these issues continue to be organizational challenges. Considering the need for new nurses to have a supportive foundation for their career and to further encourage workplace satisfaction and retention, the following PICOT question was developed: In a healthcare organization, how does an official mentor program, compared with not having a mentor program, influence nursing retention and nursing job satisfaction over 2 …

Dnp Final Report: Changing Admission Criteria In A Vocational Nursing Program To Decrease Attrition, Gabrielle O. Davis

DNP Final Reports

By the year 2030 Texas will have a shortage of 33,500 Licensed Vocational Nurses (LVN). The LVN is responsible for providing safe, compassionate and focused nursing care to assigned patients with predictable health care needs. Most LVNS work in settings caring for our ever increasing and aged population. To combat the coming shortage VN programs need to graduate safe, competent, and compassionate nurses, but programs across the state are experiencing high student attrition rates. Admission criteria is a common method to determine student success in nursing programs. This evidence-based practice improvement project synthesized evidence and integrated best practices along with …

Controlled Donation After Circulatory Death: Benchmark Study, Marilyn R. Strait

MSN Capstone Projects

Abstract

In potential organ donors after circulatory death (P), does the utilization of an evidence-based critical pathway from identification of potential donor to organ donation (I) versus no utilization of an evidence-based critical pathway (C) increase the rate of organ procurement and the satisfaction of donor families with the donation process (O)? A benchmark study was conducted to answer this question, and in short, yes, it does. The utilization of a critical pathway, when individualized to a local population and hospital’s organization increases the organ procurement rate, the donor family satisfaction with the process, and increases staff satisfaction with the …

Implementation Of A Patient Acuity Tool And The Impact On Nurse Satisfaction, Amber M. Denson

MSN Capstone Projects

Increased workloads contribute to nurse stress, affect nurse-patient relationships, and can ultimately lead to nurse turnover (O’Connell, Nettleton, Bunting, & Eichar, 2020). Nurse satisfaction can also be influenced by nurse-patient assignments (Allen, 2019). Implementation of a patient acuity tool (PAT) to balance workload and evenly distribute patient acuity in nurse-patient assignments can improve nurse job satisfaction, quality of care, and nurse retention (Firestone-Howard, Gonzalez, Dudjak, & Rader, 2017; Al-Dweik & Ahmad, 2019).

Discussions were held on a 20-bed medical-surgical unit in an acute care hospital with stakeholders that included the nurse manager, charge nurses and bedside nurses at staff meetings …

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 …

Exploring Help-Seeking Intentions Of Homeless Veterans Attending A Stand Down Event, Tara Vaughn

Nursing Theses and Dissertations

Lack of help-seeking behavior among homeless veterans results in higher burden of disease and lower quality of life. No studies have been conducted involving help- seeking intentions of homeless veterans within the veteran stand down population. Pender’s Revised Health Promotion Model was used to guide this descriptive correlational study with the aim of exploring the extent selected personal characteristics and experiences and behavior-specific factors affect help-seeking intentions among homeless veterans attending a stand down event.

A convenience sample of 86 homeless veterans (mean age 56) was recruited from a 3-day veteran stand down event in Northern California. Each participant was …

Research, Evidence-Based Practice And Quality Improvement, Tonya Traylor

DNP Final Reports

Background: The United States is in the midst of an opioid epidemic. In 2012 alone there were approximately 259 million prescriptions written by primary care providers for opioids painkillers. The U.S. Center for Disease Control (CDC) now has new guidelines and recommendation due to the opioid analgesic epidemic. Education has been found to raise provider awareness and, subsequently, has decreased opioid use. Provider education helps with reinforcing the short-term use of opioids and adjunctive therapies and helps reinforce the idea of an individualized treatment plan for patients. Purpose: The purpose of this intervention is to increase provider education on opioid …

Diabetes Shared Medical Appointment: An Evidence-Based Innovation Project, Mohamed Bojang

DNP Final Reports

The purpose of the evidence-based practice innovation project (EPIP) is to address uncontrolled diabetes by implementing an evidence-based shared medical appointment (SMA) intervention which based on the body of the evidence will help improve diabetes outcomes. A pilot implementation and retrospective chart review were conducted. Data was collected on outcome indicators such as blood pressure, lipid values, body mass index, A1C, and knowledge. The results of a pilot SMA implementation revealed that patients who participated in the weekly SMA saw an improvement in post-mean values compared to pre-mean values. Mean A1c dropped to 7.0% from 7.11%; systolic blood pressure improved …

An Evidence-Based Project: Implementing A Nursing Handoff Protocol To Improve Patient Outcomes, Marcella Y. Upshaw-Owens

DNP Final Reports

The role of handoff communication is known to impact the patient experience and other patient outcomes. Handoffs are a common practice in healthcare and occur multiple times a day for each patient. Nurses are involved in handoff each shift. Based on clinical inquiry, the following question was postulated: In acute care nurses, how does a standardized handoff communication protocol, compared to no standardized communication protocol, affect outcomes (i.e., patient satisfaction, falls, medication errors, and missed orders) within a 3-month period? After completion of a literature review and critical appraisal, a bedside report protocol was developed and implemented using the Iowa …

Simulated Role-Play To Improve Attitudes And Empathy Towards Older Adults In Accelerated Nursing Students, Elizabeth A. Galetz

Nursing Theses and Dissertations

Nearly 18% of the United States population will be at least 65 years or older by 2025. Studies suggest student nurses have a negative attitude toward working with this population. There is a need to increase the number of graduate nurses who have positive attitudes towards older adults and an interest in working with this population upon graduation. This pre- and post-test intervention study aimed to: 1) examine the effectiveness of two educational modalities, a case study and simulated role-playing scenarios, on improving attitudes and empathy towards older adults; 2) explore factors affecting attitudes and empathy in accelerated baccalaureate of …

Effect Of Metacognitive Strategy On Nursing Students’ Achievement And Engagement In An Active Learning Exercise, Theresa M. Naldoza

Nursing Theses and Dissertations

Nurse educators are responsible for producing nurse graduates that are competent, safe, and prepared to manage the complex clinical situations they will face. These graduates must possess sound clinical judgment skills that ensure safe and effective delivery of patient care. The decreasing capacity of clinical placements available for students to acquire hands-on experience presents an additional challenge. Educators must develop and implement innovative, effective teaching strategies to address these issues. An initial comparative concept analysis of engagement and reciprocity focused on the educator-student relationship as one in which all members contribute to the learning atmosphere is included in Chapter 2. …

Impact Of Podcasting On Learning Outcomes In Associate Degree Nursing Students, Daira D. Wilson

Nursing Theses and Dissertations

The dawn of the Information Age has provided rapid advances in technology that have improved lives and produced better tools for caring for each other. Nursing has begun to employ many of these new technologies and nurses are at the forefront of deciding how these innovations might best help patients. New technologies have made their way into schools of nursing and students are benefitting from improved learning experiences. Nursing faculty are leading the way in providing new learning opportunities to students through a multitude of technological advances. One of these advances is podcasting. Podcasting provides students the ability to listen, …

Bariatric Surgery Weight-Loss Maintenance Among Hispanics: A Multiple Case Study, Minerva Aguilera

Nursing Theses and Dissertations

Obesity significantly contributes to human illness and to subsequent rising healthcare expenditures. Bariatric surgery has been identified as the only effective option to achieve the weight loss necessary for those who are morbidly obese. Previous research indicated that maintaining significant weight loss has been a problem for individuals who undergo bariatric surgery. The number of bariatric surgeries is increasing and factors that contribute to or interfere following bariatric-surgery weight-loss maintenance need to be determined. Research on weight-loss maintenance following bariatric surgery is very limited, particularly among the Hispanic population. This case-study research used an explanatory, multiple-case-study design to gain greater …